Evidence map›Paper›PMID 42752752›Full record

ArticleAdvances in therapy2026

Impact of Uncontrolled Motor Fluctuations in Parkinson's Disease: Real-World Insights from the PROSPECT Observational Study.

Alberto J Espay, Luc Defebvre, Oriol de Fabregues, Drew Falconer, Kazuko Hasegawa, David Houghton, David Ledingham, Alexander Lehn, Tiago A Mestre, Tomoko Oeda and 9 more

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Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Alberto J EspayUniversity of Cincinnati Gardner Neuroscience Institute, Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, 234 Goodman Street, Cincinnati, OH, 45219, USA. espayaj@ucmail.uc.edu.
Luc DefebvreMovement Disorders Department, Lille Neurosciences and Cognition, CHU Lille, Lille University, Lille, France.
Oriol de FabreguesDepartment of Neurology, Vall d,Hebron Institut de Recerca (VHIR), Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Barcelona, Spain.
Drew FalconerInova Parkinson's and Movement Disorders Center, Falls Church, VA, USA.
Kazuko HasegawaDepartment of Neurology, NHO Sagamihara National Hospital, Kanagawa, Japan.
David HoughtonDepartment of Neurology, Ochsner Clinic Foundation, New Orleans, LA, USA.
David LedinghamDepartment of Neurology, Newcastle Hospitals, Newcastle Upon Tyne, UK.
Alexander LehnDepartment of Neurology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Tiago A MestreDivision of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Tomoko OedaClinical Research Center and Department of Neurology, National Hospital Organization Unato National Hospital, Kyoto, Japan.
Fabienne Ory-MagneDepartment of Neurology, University Hospital of Toulouse, Toulouse, France.
Justyna R SarnaDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Delaram SafarpourDepartment of Neurology, Oregon Health and Science University, Portland, OR, USA.
Sam ColmanReal World Evidence and Analytics, Fortrea, Sydney, NSW, Australia.
Lars BergmannAbbVie Inc, North Chicago, IL, USA.
Pavnit KukrejaAbbVie Inc, North Chicago, IL, USA.
Koray OnukAbbVie Inc, North Chicago, IL, USA.
Connie H YanAbbVie Inc, North Chicago, IL, USA.
Pilar Sanchez AlonsoMovement Disorders Unit, Neurology Department, Hospital U Puerta de Hierro, Majadahonda, Madrid, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLimited real-world data exist around the long-term impact of uncontrolled motor fluctuations in Parkinson's disease (PD). With this first-ever, prospective, observational study, we sought to describe real-world treatment patterns and longitudinal outcomes of patients with PD and motor fluctuations inadequately controlled by oral medications.

methodsPROSPECT was a 24-month multicountry observational study that included 229 adults with idiopathic PD and uncontrolled motor fluctuations (≥ 2.5 h/day "off" time) on optimized oral PD medications who were device-aided therapy-naive. Treatment modifications, including adding device-aided therapy, were made as part of routine clinical care and were not assigned by the study. Assessments included change from baseline (CFB) in motor and non-motor symptoms, activities of daily living (ADL; MDS-UPDRS Part II), and quality of life (QoL; EQ-5D-5L, PDQ-39). Outcomes were adjusted for baseline differences using linear regression. Subgroup analyses were performed among those who remained on oral PD medications only and those who initiated device-aided therapy.

resultsMost patients (80.3%, n = 184) remained solely on oral PD medications due to clinician not offering or patient refusal, and showed a small reduction in "off" time (CFB - 0.7 h/day, p = .006) at 24 months, with nominal decline in ADL (CFB = 1.5, p = .010) and QoL (PDQ-39 CFB = 2.6, p = .010; EQ-5D-5L CFB = - 0.04, p = .017). Approximately half (49.8%, n = 114) were offered device-aided therapy, of whom 44.7% (n = 51/114) declined, mainly citing needing time to decide or perception as unnecessary. Patients who initiated device-aided therapy (19.7%, n = 45) showed a meaningful "off" time reduction (CFB = - 2.2 h/day, p < .0001) and no change in ADL and QoL at 24 months, versus slight worsening with oral medications only.

conclusionDespite device-aided therapy eligibility, most patients with PD remained exclusively on oral medications. Device-aided therapy initiation was associated with improved motor symptoms, while those who remained on oral medications showed no meaningful change.

Indexed as

Advanced Parkinson’s diseaseDevice-aided therapyLevodopa–carbidopa intestinal gelMotor fluctuations“off” timeQuality of lifeReal-World Evidence

Identifiers

PMID42752752

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.