Objective: To assess the impact of LIDs on HRQoL in this large sample of unselected Parkinson’s Disease (PD) patients and to assess the factors related to its presence.

Background: Levodopa-induced dyskinesias (LIDs) often complicate the course of dopaminergic replacement therapy. The relative impact of LIDs and motor fluctuations has not been sufficiently explored so far.

Methods: 683 PD patients of the COPARK survey were evaluated. All patients were assessed in a standardized manner: demographics, treatments, Unified PD Rating Scale (UPDRS), and Hospital Anxiety and Depression Scale and HRQoL scales (primary outcome: PDQ-39, secondary outcome: SF-36). LIDs daily duration and disability were obtained from UPDRS IV items #32 and #33. Daily duration of wearing-off was obtained from UPDRS IV item #36 and disability was calculated as UPDRS II in OFF- minus ON-state. T-test was employed to compare HRQoL scores between PD patients with or without LIDs. Multivariate testing was performed by logistic regression. The relative contribution of LIDs or wearing-off duration and disability to HRQoL scores was modelled by ANOVA, with eta² scores representing the effect size of each analyzed factor.

Results: 183 PD patients (26.8%) suffered from LIDs. Significant differences between patients with or without LIDs were detected in PDQ-39 total score (33.1±1.1 vs 45.4±2.1, p<0.01) as well as in SF-36 physical component score (70.4±1.1 vs 59.1±2.0, p<0.01) and mental component score (60.6±0.7 vs 54.8±1.3, p<0.01). Worse PDQ-39 mobility and bodily discomfort subscores. PDQ-39 was related to wearing-off duration (eta²= 3.0%, p<0.01) and LIDs disability (eta²= 1.3%, p<0.04). Factors independently and significantly related to LIDs were levodopa dose and therapy duration, daily equivalent dose of other dopaminergic drugs, age at PD onset, and anxiety. Exposure to oral hypoglucemiants and tremor were protective factors.

Conclusions: In this study, LIDs correlated with worse HRQoL, specially with feelings of altered mobility and bodily discomfort. PDQ-39 total scores was independently affected by LIDs disability and wearing-off duration. Anxiety affected LIDs negatively and exposure to oral hypoglycemiants was a protective factor, which has not been reported before.

References: This abstract has been submitted to the 4th World Parkinson Congress (2016)

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-levodopa-induced-dyskinesias-on-health-related-quality-of-life-results-from-the-french-copark-study/