Levetiracetam for the management of levodopa-induced dyskinesias in Parkinson's
disease.
Author(s): Stathis P, Konitsiotis S, Tagaris G, Peterson D; VALID-PD Study Group.
Collaborators: Stathis P, Konitsiotis S, Tagaris G, Hadjigeorgiou G, Kiriakakis
V, Maltezou M, Karakasis P, Alexoudi A, Sakkou V, Dardiotis E, Kountra P.
Affiliation(s): Department of Neurology, 1st Hospital of Social Security Services, Athens,
Greece. statneur@hol.gr
Publication date & source: 2011, Mov Disord. , 26(2):264-70
The efficacy and safety of levetiracetam (LEV), administered for management of
levodopa-induced dyskinesias (LID) in Parkinson's disease (PD), was examined
using a multicenter, double-blind, placebo-controlled, parallel groups, crossover
trial. Because of having a period effect, data after crossover point was excluded
from analysis. Levodopa-treated PD participants with LID (n = 38) received LEV
500 mg/day, were assessed, titrated to 1,000 mg/day and reassessed, before and
after crossover. The placebo group followed the same routine. Primary efficacy
was defined from percent change in "On with LID" time from patient diaries.
Secondary efficacy assessment used "On without LID," "Off" time, unified PD
rating scale (UPDRS), clinical global impression (CGI), and Goetz dyskinesia
scale after levodopa challenge. Safety measures were also performed. On with LID
time decreased 37 minutes (95% confidence interval [CI] 0.59, 7.15; P = 0.02) at
500 mg/day, 7.85% 75 minutes (95% CI 3.3, 12.4; P = 0.002) at 1,000 mg/day. On
without LID time increased by 46 minutes (95% CI -1.55, -0.03; P = 0.04) at 500
mg/day and 55 minutes (95% CI -10.39, -1.14; P = 0.018) at 1,000 mg/day. UPDRS 32
showed decreased dyskinesia duration mean change 0.35 (95% CI 0.09, 0.5; P =
0.009) at 1,000 mg/day. CGI showed LID decreased by 0.7 (95% CI 0.21, 1.18; P =
0.006) at 1,000 mg/day. Patient diaries and UPDRS show no increase in Off time.
This exploratory trial provides evidence that LEV in 1,000 mg/day, slowly
titrated, could be useful in improving LID as was assessed with patient diaries,
UPDRS, and CGI scales, safely, with minimal side effects.
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