ArticleMovement disorders : official journal of the Movement Disorder Society2021
Estimating the Effect of Early Treatment Initiation in Parkinson's Disease Using Observational Data.
Article in Movement disorders : official journal of the Movement Disorder Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis.Frontiers in aging neuroscience · 2023Pooled it
- The effect and safety of levodopa alone versus levodopa sparing therapy for early Parkinson's disease: a systematic review and meta-analysis.Journal of neurology · 2022Pooled it
- Assessing healthcare resource utilization burden and unmet treatment needs in patients with Parkinson's disease: results from a real-world study.Journal of comparative effectiveness research · 2025Article
- Effect of Early Levodopa Treatment on Mortality in People with Parkinson's Disease.Movement disorders clinical practice · 2024Article
- Action observation treatment may improve daily living activities and verb recovery in Parkinson's disease-dementia: findings from a preliminary randomized controlled trial.Frontiers in aging neuroscience · 2024Article
- Article
- The effect of cardiovascular risk on disease progression inFrontiers in neurology · 2023Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBoth patients and physicians may choose to delay initiation of dopamine replacement therapy in Parkinson's disease (PD) for various reasons. We used observational data to estimate the effect of earlier treatment in PD. Observational data offer a valuable source of evidence, complementary to controlled trials.
methodWe studied the Parkinson's Progression Markers Initiative cohort of patients with de novo PD to estimate the effects of duration of PD treatment during the first 2 years of follow-up, exploiting natural interindividual variation in the time to start first treatment. We estimated the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III (primary outcome) and several functionally relevant outcomes at 2, 3, and 4 years after baseline. To adjust for time-varying confounding, we used marginal structural models with inverse probability of treatment weighting and the parametric g-formula.
resultsWe included 302 patients from the Parkinson's Progression Markers Initiative cohort. There was a small improvement in MDS-UPDRS Part III scores after 2 years of follow-up for patients who started treatment earlier, and similar, but nonstatistically significant, differences in subsequent years. We found no statistically significant differences in most secondary outcomes, including the presence of motor fluctuations, nonmotor symptoms, MDS-UPDRS Part II scores, and the Schwab and England Activities of Daily Living Scale.
conclusionEarlier treatment initiation does not lead to worse MDS-UPDRS motor scores and may offer small improvements. These findings, based on observational data, are in line with earlier findings from clinical trials. Observational data, when combined with appropriate causal methods, are a valuable source of additional evidence to support real-world clinical decisions. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Registered trials
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