Objective: Parkinson’s disease (PD) is one of common progressive neurodegenerative disorder involving nigrostriatal dopaminergic neurons. The aim of this study was to investigate risk factors of WO in patients with PD in Japan.

Background: With PD progressed, wearing-off (WO) phenomenon occurred as motor complications. WO phenomenon decreased quality of life of PD patients. STIRIDE-PD study demonstrated that risk of WO is increased by young age of onset, high score in Unified Parkinson’s disease rating scale (UPDRS) of part II and III, female patients, and patients in North America. We performed this study to investigate risk factors of WO in patients with PD in Japan.

Methods: The diagnosis of PD was based on the United Kingdom PD Society Brain Bank criteria. WO was defined as “the generally predictable recurrence of motor and non-motor symptoms that precedes the administration of scheduled doses of antiParkinsonian medication and usually improves after these doses.” The physicians assessed each PD patient as having WO based on the findings of clinical assessments and interviews conducted during the single visit. The risk factors of WO were investigated by multivariate logistic regression analysis.

Results: The odd ratio of patients aged 69 or older was 0.2 (95 CI 0.08-0.51, P=0.015) compared with those aged 56 years or younger. The OR of female was 5.57 (95 CI 2.16-14.38, P<0.001) compared with male. The OR of daily levodopa over 600mg/day was 9.65 (95 CI 1.92-48.34, P<0.001) compared with those under 300mg/day.

Conclusions: The results of multivariate logistic regression analysis demonstrated that age of onset, sex, and daily levodopa dose were associated with occurrence of WO. These results suggest that physicians should be careful for treatment with patients with young onset and female and use low dose of levodopa.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-factors-of-wearing-off-phenomenon-in-parkinsons-disease-in-japan/