Session Information
Date: Thursday, June 8, 2017
Session Title: Parkinson’s Disease: Clinical Trials, Pharmacology And Treatment
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: To characterize early morning OFF problems in consecutive PD patients attending a routine clinical appointment.
Background: In PD patients with motor fluctuations, total daily OFF time is comprised of end-of-dose wearing-off and the time taken to turn ON with medication. Whereas the impact of wearing-off has been well characterised, less is known about the impact of delays in ON time.
Methods: This was a single visit study of consecutive PD patients attending a routine appointment at a single referral center. During the single visit, patients (aged ≥18 years) with idiopathic PD (Hoehn and Yahr I-III during ON) and treated with levodopa (time since starting levodopa ≥1 year & stable dose for ≥4 weeks) were invited to complete Parts A and B of the Time-to-ON Questionnaire (TOQ; Part A = time waiting for ON; Part B = symptoms experienced while waiting to turn ON) and were then asked to complete Part C (time-to-ON diary, where the patient documented over 5 days how long it took to turn ON following their first morning dose of levodopa in 5 minute increments).
Results: 150 patients (mean age: 69.3 years, duration PD: 7.5 years, total UPDRS score: 36.5) completed the survey. Just over a third of patients (53/150, 35.3%) reported delays in ON time following their first morning dose (on average for 2.5 of the previous 7 days). The most common symptoms experienced while waiting for ON were: slowness (61.3%), fatigue (56.7%), reduced dexterity (53.3%), difficulties in walking (44.0%) and problems with balance (38.7%). According to patient diaries (over the 5 days), the mean time to ON following the first morning dose of levodopa ranged from 34.0 to 39.8 minutes.
Conclusions: These data indicate that early morning OFF problems are common in PD patients, with some patients waiting over 30 minutes to turn ON following their first morning dose of levodopa.
To cite this abstract in AMA style:
F. Stocchi, C. Coletti, S. Bonassi, L. Vacca. Early morning OFF problems are common in PD patients attending a routine clinical appointment [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/early-morning-off-problems-are-common-in-pd-patients-attending-a-routine-clinical-appointment/. Accessed June 15, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/early-morning-off-problems-are-common-in-pd-patients-attending-a-routine-clinical-appointment/