Systematic review of levodopa dose equivalency reporting in Parkinson's disease†
Corresponding Author
Claire L. Tomlinson PhD
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Birmingham Clinical Trials Unit, Robert Aitken Institute for Clinical Research, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United KingdomSearch for more papers by this authorRebecca Stowe PhD
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorSmitaa Patel MSc
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorCaroline Rick PhD
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorRichard Gray MSc
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorCarl E. Clarke MD
Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, United Kingdom
School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
Search for more papers by this authorCorresponding Author
Claire L. Tomlinson PhD
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Birmingham Clinical Trials Unit, Robert Aitken Institute for Clinical Research, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United KingdomSearch for more papers by this authorRebecca Stowe PhD
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorSmitaa Patel MSc
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorCaroline Rick PhD
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorRichard Gray MSc
Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
Search for more papers by this authorCarl E. Clarke MD
Department of Neurology, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, United Kingdom
School of Clinical and Experimental Medicine, College of Medicine and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
Search for more papers by this authorPotential conflict of interest: Nothing to report.
Abstract
Interpretation of clinical trials comparing different drug regimens for Parkinson's disease (PD) is complicated by the different dose intensities used: higher doses of levodopa and, possibly, other drugs produce better symptomatic control but more late complications. To address this problem, conversion factors have been calculated for antiparkinsonian drugs that yield a total daily levodopa equivalent dose (LED). LED estimates vary, so we undertook a systematic review of studies reporting LEDs to provide standardized formulae. Electronic database and hand searching of references identified 56 primary reports of LED estimates. Data were extracted and the mean and modal LEDs calculated. This yielded a standardized LED for each drug, providing a useful tool to express dose intensity of different antiparkinsonian drug regimens on a single scale. Using these conversion formulae to report LEDs would improve the consistency of reporting and assist the interpretation of clinical trials comparing different PD medications. © 2010 Movement Disorder Society
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