Abstract
BackgroundAlthough dopamine agonists (DAs) are useful in Parkinson′s disease (PD), they are not frequently used in elderly patients due to adverse effects. However, there is a lack of evidence because few elderly PD patients are enrolled in clinical trials.Aims of the studyThe aims of this study were to analyze the reasons of DA withdrawal (DAW) in a group of PD patients in clinical practice and to identify the related factors. Specifically, we studied the effect of age, comorbidity, and polypharmacy as potential risk factors for DAW.MethodsA retrospective chart review of the follow‐up (from May, 2012 to March, 2015) of a subgroup of PD patients receiving a DA (n = 68; 60.3% males, 69.3 ± 9.2 years old) from a cohort (n = 150) previously studied in detail in 2012 was used to identify predictive factors of DAW.ResultsThe DAW percentage was 18.2% (12/66; follow‐up of 690.2 ± 232.6 days). DAW causes were cognitive impairment (3), reduction therapy (3), hallucinations (2), dyskinesia (2), and excessive diurnal somnolence (2). Only a higher levodopa daily dose (HR 1.003; 95% CI 1.001–1.006; P = 0.044) was an independent predictor of DAW after adjustment for other explanatory variables.ConclusionsThe frequency of DAW was low. Advanced age alone is not a contraindication to the administration of DAs.
Highlights
Levodopa is the gold standard symptomatic treatment in Parkinson0s disease (PD), its long-term use is associated with the development of motor complications
We studied the effect of age, comorbidity, and polypharmacy as potential risk factors for DA withdrawal (DAW)
Age was not related to DAW
Summary
Levodopa is the gold standard symptomatic treatment in Parkinson0s disease (PD), its long-term use is associated with the development of motor complications. DAs are associated with a greater risk of developing dopaminergic side effects (somnolence, hallucinations, edema, impulse control disorders, etc.) compared with levodopa, and their use is avoided in the elderly for reasons including altered drug metabolism, an increased risk of adverse effects, increased comorbid conditions, increased risk of drug interactions, and a higher risk of cognitive problems and behavior disorders in PD patients over the age of 70 years (Kempster et al.2007; Stowe et al 2008). The aims of this study were as follows: (1) to determine the reasons of DA withdrawal (DAW) in a group of PD patients in clinical practice; and (2) to identify the predictive factors of DAW. Dopamine agonists (DAs) are useful in Parkinson0s disease (PD), they are not frequently used in elderly patients due to adverse effects. Advanced age alone is not a contraindication to the administration of DAs
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