SAN DIEGO—Patients with early Parkinson’s disease who started treatment with a rotigotine transdermal patch six months earlier than other patients at a similar stage of the disease had a slower return to baseline mean Unified Parkinson’s Disease Rating Scale (UPDRS) II and III scores, according to research presented at the 19th International Congress of Parkinson’s Disease and Movement Disorders. Initiating treatment sooner in early Parkinson’s disease may be associated with long-term benefit, researchers said.
Lars Timmermann, MD, Professor of Neurological Movement Disorders at University Hospital Cologne in Germany, and his research colleagues performed a post hoc analysis of pooled data from two double-blind, placebo-controlled studies of six-month maintenance and the studies’ open-label extensions. The researchers compared patients at Hoehn and Yahr stages 1 and 2 who received rotigotine during the double-blind studies and open-label extensions with those who received placebo during the double-blind studies and rotigotine in the open-label extensions.
The analysis included 221 patients who received rotigotine in the double-blind studies (mean age 60.9, 67.9% male) and 125 patients who initiated rotigotine treatment six months later (mean age 63, 66.4% male). Mean UPDRS II and III scores at double-blind baseline were similar for the two groups: 29.3 for those who started on rotigotine and 27.8 for those who first received placebo. At the beginning of the open-label study, mean change from baseline UPDRS score was –8.5 for those who had received rotigotine and –7.7 for those who had received placebo. After this initial improvement, scores gradually returned to baseline. Among patients who started rotigotine six months earlier, mean UPDRS returned to the double-blind baseline after approximately 42 months. Among patients who started rotigotine treatment later, mean UPDRS returned to baseline after approximately 18 months.
“While there are no established disease-modifying or neuroprotective therapies [for Parkinson’s disease], timing of therapy initiation is of clinical importance, and earlier initiation has been shown to improve quality of life,” Dr. Timmermann said. “Earlier initiation of rotigotine in early Parkinson’s disease patients at Hoehn and Yahr [stages] 1–2 may be associated with additional long-term benefit.”
—Jake Remaly