Objective: To compare clinical outcomes of patients with Parkinson’s disease (PD) with moderate and severe motor fluctuations or dyskinesia managed with oral dopaminergic medications vs device-aided therapies (DATs)

Background: Optimizing treatment regimens for patients with advanced PD with motor fluctuations is a challenge. Management of these patients varies among providers as only a subset receive DATs like carbidopa-levodopa enteral suspension or deep-brain stimulation (DBS). Many patients remain on complex oral treatment regimens. As a result, decreased compliance and poor symptom control may occur. There is a lack of standardized criterion for determining appropriate therapeutic recommendations to optimize outcomes for these patients. Limited data are available on outcomes in patients who remain on oral treatment vs those who switch to DATs; this study seeks to understand and assess clinical outcomes in these patients.

Method: We will retrospectively analyze clinical data of patients with advanced PD with moderate and severe motor fluctuations or dyskinesia from a registry database. Patient eligibility is defined by a PD diagnosis of >5 years, presence of moderate motor fluctuations or dyskinesias, and treatment with levodopa ≥4 times/day or a levodopa equivalent dose >400 mg/day. Eligible patients will be divided into 2 cohorts: (1) those who “Remain” on Oral Therapy and (2) those who “Switch” to DAT. As the primary objective, we will compare change between cohorts in quality of life (QoL) measured by the Parkinson’s Disease Questionnaire (PDQ-39) from baseline to month 12. Secondary objectives include comparisons of both cohorts’ change from baseline to month 12 in UPDRS parts I–IV. Exploratory analyses will include longer-term (>12 month) analyses of the above motor data, and comparisons in non-motor symptoms including mood-related and impulsivity measures.

Results: We intend to analyze and compare change in PDQ-39 and other measures from baseline to month 12 for the “Remain” Cohort (n = 314) vs the “Switch” Cohort (n = 350). The study is ongoing and results are not available at this time.

Conclusion: Data from this analysis will provide meaningful insight on the relevance of timely intervention and impact of switching to DAT on QoL and disease burden in people with advanced PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/registry-analysis-in-progress-to-evaluate-clinical-outcomes-and-disease-burden-of-advanced-pd-in-patients-with-motor-fluctuations-and-dyskinesia-managed-with-oral-dopaminergic-therapies-versus-devic/