Long-term effect of controlled-release carbidopa/levodopa in levodopa-na

This study reports long-term (over 6 years) effect of controlled-release carbidopa/levodopa (CRCL, Sinemet-CR) in levodopa-naive Parkinson's disease patients. Parkinsonian features were evaluated utilizing the Northwestern University Disability Scale (NUDS) and modified New York University Parkinson's Disease Rating Scale (NYUPDRS). The NUDS scores showed significant variation over time by 2-way ANOVA (P < 0.0001). Following treatment, compared to baseline scores, the NYUPDRS scores showed significant improvement in rigidity, tremor, bradykinesia, while the postural stability scores worsened and gait scores, after initial improvement, returned to baseline level. At the end of the study period 5 patients were alive, 1 became disabled due to myocardial infarction and 3 were holding on to full time occupations. Three patients developed medication related dyskinesia, 1 developed myoclonus and 1 developed a combination of dyskinesia, motor fluctuations and early morning dystonia. Due to small number of patients, while a definite conclusion cannot be drawn, it appears that the incidence of motor fluctuation may be much less prevalent than dyskinesia in patients with Parkinson's disease treated with CRCL.