No sex differences in use of dopaminergic medication in early Parkinson disease in the US and Canada - baseline findings of a multicenter trial.

Chizoba C Umeh,Rohit Dhall,Zoltan Mari,Chadwick W Christine,Anne-Marie A Wills,Richard B Dewey,Erika F Augustine,Oksana Suchowersky,Adriana Pérez,David K Simon,Jay S Schneider

doi:10.1371/journal.pone.0112287

Abstract

BackgroundSex differences in Parkinson disease clinical features have been reported, but few studies have examined sex influences on use of dopaminergic medication in early Parkinson disease. The objective of this study was to test if there are differences in the type of dopaminergic medication used and levodopa equivalent daily dose between men and women with early Parkinson disease enrolled in a large multicenter study of Creatine as a potential disease modifying therapy – the National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson Disease Long-Term Study-1.MethodsBaseline data of 1,741 participants from 45 participating sites were analyzed. Participants from the United States and Canada were enrolled within five years of Parkinson Disease diagnosis. Two outcome variables were studied: type of dopaminergic medication used and levodopa equivalent daily dose at baseline in the Long-Term Study-1. Chi-square statistic and linear regression models were used for statistical analysis.ResultsThere were no statistically significant differences in the frequency of use of different types of dopaminergic medications at baseline between men and women with Parkinson Disease. A small but statistically significant difference was observed in the median unadjusted levodopa equivalent daily dose at baseline between women (300 mg) and men (325 mg), but this was not observed after controlling for disease duration (years since Parkinson disease diagnosis), disease severity (Unified Parkinson's Disease Rating Scale Motor and Activities of Daily Living Scores), and body weight.ConclusionsIn this large multicenter study, we did not observe sex differences in the type and dose of dopaminergic medications used in early Parkinson Disease. Further research is needed to evaluate the influence of male or female sex on use of dopaminergic medication in mid- and late-stage Parkinson Disease.

Highlights

Sex differences in medical treatment have been reported in the pain and cardiovascular medicine literature, with men receiving more aggressive treatment for these conditions. [1, 2] When assessing sex differences in stroke- a prevalent neurological condition- women are less likely than men to receive thrombolytic treatment with alteplase and are reported to have poorer stroke-related outcomes including greater disability and lower quality of life. [3] Disparities in treatment based on sex can have a significant impact on morbidity, mortality, and quality of life.Sex differences in the clinical characteristics of Parkinson Disease (PD) have been frequently reported, little is known about the influence of male or female sex on treatment for this common condition
The objective of this study was to test if there are differences in the type of dopaminergic medication used and levodopa equivalent daily dose between men and women with early Parkinson disease enrolled in a large multicenter study of Creatine as a potential disease modifying therapy – the National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson Disease Long-Term Study-1
A small but statistically significant difference was observed in the median unadjusted levodopa equivalent daily dose at baseline between women (300 mg) and men (325 mg), but this was not observed after controlling for disease duration, disease severity (Unified Parkinson’s Disease Rating Scale Motor and Activities of Daily Living Scores), and body weight

Summary

Introduction

Sex differences in medical treatment have been reported in the pain and cardiovascular medicine literature, with men receiving more aggressive treatment for these conditions. [1, 2] When assessing sex differences in stroke- a prevalent neurological condition- women are less likely than men to receive thrombolytic treatment with alteplase and are reported to have poorer stroke-related outcomes including greater disability and lower quality of life. [3] Disparities in treatment based on sex can have a significant impact on morbidity, mortality, and quality of life.Sex differences in the clinical characteristics of Parkinson Disease (PD) have been frequently reported, little is known about the influence of male or female sex on treatment for this common condition. [5] These sex differences in clinical characteristics could influence the type and dose of dopaminergic medications used in early PD. [6] In another study by Lyons et al, men with disease duration of greater than 5 years were taking significantly higher daily doses of levodopa compared to women of similar disease duration, but this sex difference was not present in subjects with disease duration less than 5 years. The objective of this study was to test if there are differences in the type of dopaminergic medication used and levodopa equivalent daily dose between men and women with early Parkinson disease enrolled in a large multicenter study of Creatine as a potential disease modifying therapy – the National Institute of Neurological Disorders and Stroke Exploratory Trials in Parkinson Disease Long-Term Study-1. Chi-square statistic and linear regression models were used for statistical analysis

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