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New study in NEJM suggests levodopa may slow progression of Parkinson's disease

Levodopa is the most powerful drug available to treat the symptoms of Parkinson disease, and almost all patients with the disease will eventually need to take it. But there has long been controversy about when it should be started, in part because of concern that the medicine itself might cause further damage to the brain cells that are impaired in this disease. To resolve the controversy, a Columbia University scientist led a team of experts from the Parkinson Study Group to study levodopa's effect on the rate of progression of the disease.

The study, reported in the December 9 issue of The New England Journal of Medicine, showed not only that levodopa does not appear to worsen the disease, but that it may actually slow its progression. A total of 38 Parkinson Study Group sites across the U.S. and Canada conducted this multi-center, placebo-controlled, double-blind clinical trial involving 361 newly diagnosed Parkinson disease patients.

Stanley Fahn, M.D., professor of neurology at Columbia University Medical Center, was the principal investigator of the study. "Although there is still uncertainty on how to interpret the study and further investigation will be necessary to prove levodopa's value beyond reasonable doubt, we found that levodopa did not accelerate the pace of Parkinson disease," said Dr. Fahn. "Now patients can feel more secure about the drug and may wish to start it sooner rather than later."

The co-principal investigator, Ira Shoulson, M.D., professor of neurology at the University of Rochester, added, "The results of this study are important because they help provide confidence for both patients with Parkinson disease and their doctors about the safety of levodopa." Drs. Fahn and Shoulson advised, however, "The results do not prove that levodopa slows the underlying nerve degeneration of Parkinson disease, and a differently designed clinical study will be necessary to address this concept." A follow-up study is al
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Contact: Karen Zipern
kz2110@columbia.edu
212-305-9746
Columbia University Medical Center
8-Dec-2004


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