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Absence of wearing-off in Parkinson’s disease patients with treatment beyond 10 years

Q. Wei, R. Ou, Y. Wu, X. Yuan, Y. Hou, H. Liu, L. Zhang, Y. Chen, B. Cao, X. Chen, H. Shang (Chengdu, China)

Meeting: 2018 International Congress

Abstract Number: 335

Keywords: Dyskinesias, Parkinsonism, Wearing-off fluctuations

Session Information

Date: Saturday, October 6, 2018

Session Title: Parkinson’s Disease: Clinical Trials, Pharmacology And Treatment

Session Time: 1:45pm-3:15pm

Location: Hall 3FG

Objective: This study aims to explore the determinants for absence of wearing-off in patients with Parkinson’s disease (PD) based on a large cohort of Chinese population.

Background: Not all patients with PD will develop wearing-off after levodopa treatment.

Methods: An observational analysis of 234 Chinese PD patients who had received anti-parkinson treatment beyond 10 years was conducted. Each subject was categorized as presence of wearing-off or absence of wearing-off.

Results: This study included 131 male and 103 patients, with mean age of 67.1 ± 10.3 years, with mean duration of 14.7 ± 4.7 years, with mean onset age of 52.4 ± 10.4 years, and with mean H&Y stage 3.1 ± 0.9. One hundred and forty-two patients reported wearing-off (60.7%). Patients with wearing-off showed significantly longer disease duration, longer duration of anti-Parkinson treatment, higher daily levodopa dose, higher total levodopa equivalent daily doses (LEDD), higher daily levodopa per kilogram of body weight, higher usage rate of levodopa, higher incidence of dyskinesia, and higher proportion of levodopa onset than those in patients without wearing-off (P < 0.05). The forward binary logistic regression model indicated that shorter duration of anti-Parkinson treatment (OR=0.925, 95%CI=0.866-0.988, P=0.020), lower daily levodopa dose (OR=0.998, 95%CI=0.997-0.999, P=0.006), and absence of dyskinesia (OR=3.970, 95%CI=1.906-8.269, P<0.001) were associated with the absence of wearing-off. The receiver operating characteristic (ROC) curve indicated that levodopa dosage as 350 mg/day exhibited cut-off value for wearing-off.

Conclusions: In patients with anti-parkinson treatment of more than 10 years, wearing-off may less frequently occur in patients with shorter duration of treatment. Preventing dyskinesia and maintaining levodopa dosage < 350 mg/day may help to reduce the risk of wearing-off. Our results are beneficial to clinical management of wearing-off in PD.

To cite this abstract in AMA style:

Q. Wei, R. Ou, Y. Wu, X. Yuan, Y. Hou, H. Liu, L. Zhang, Y. Chen, B. Cao, X. Chen, H. Shang. Absence of wearing-off in Parkinson’s disease patients with treatment beyond 10 years [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/absence-of-wearing-off-in-parkinsons-disease-patients-with-treatment-beyond-10-years/. Accessed June 14, 2025.
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