Early addition of selegiline to L-Dopa treatment is beneficial for patients with Parkinson disease.
OBJECTIVE
To evaluate the clinical outcome of Parkinson disease (PD) patients treated with selegiline (with L-Dopa/decarboxylase inhibitor) in the early stage of the disease in comparison with that of late-stage use of selegiline.


METHODS
The study and the reference groups were extracted from a large database of the registry of all selegiline users (4692) between year 1998 and 2003 according to the defined criteria. The study group consisted of 106 PD patients who received selegiline within 5 years from the onset of the disease and were followed up for 7 years in average. The reference group consisted of 585 PD patients with comparable disease duration who received selegiline for 16 weeks from 9 to 11 years (mean [SD], 9.9 [0.7]) after the onset of the disease, and the evaluation was made before and after the treatment with selegiline.


RESULTS
The sum of the Unified Parkinson's Disease Rating Scale (UPDRS) scores of 6 major motor symptoms of the study group was significantly lower than that of the reference group (mean [SD], 7.78 [4.30] vs 11.41 [3.88]; P < 0.0001) when compared at a point with the same disease duration (9.8 [1.7] vs 9.9 [0.7] years). The mean UPDRS score of the reference group after 4 months' treatment with selegiline did not reach that of the study group (mean [SD], 9.40 [3.76] vs 7.78 [4.30]; P = 0.0002).


CONCLUSIONS
The clinical outcome as evaluated by the selected UPDRS motor scores was better for L-Dopa-treated patients who received selegiline within 5 years from the onset compared with those who received selegiline approximately 10 years from the onset.
Mizuno
Yoshikuni
Y
Juntendo University Koshigaya Hospital, Saitama, Japan. y_mizuno@juntendo.ac.jp
Kondo
Tomoyoshi
T
Kuno
Sadako
S
Nomoto
Masahiro
M
Yanagisawa
Nobuo
N
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004185:Disability Evaluation; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D012189:Retrospective Studies; D012642:Selegiline / Q000009:adverse effects / Q000627:therapeutic use*
D000978:Antiparkinson Agents; D012642:Selegiline; D007980:Levodopa