Levodopa Dose Equivalency in Parkinson's Disease: Updated Systematic Review and Proposals

Background To compare drug regimens across clinical trials in Parkinson's disease (PD) conversion formulae between antiparkinsonian drugs have been developed. These are reported in relation to levodopa as the benchmark drug in PD pharmacotherapy as ‘levodopa equivalent dose’ (LED). Currently, t...

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Published in:Movement disorders Vol. 38; no. 7; pp. 1236 - 1252
Main Authors: Jost, Stefanie T., Kaldenbach, Marie‐Ann, Antonini, Angelo, Martinez‐Martin, Pablo, Timmermann, Lars, Odin, Per, Katzenschlager, Regina, Borgohain, Rupam, Fasano, Alfonso, Stocchi, Fabrizio, Hattori, Nobutaka, Kukkle, Prashanth Lingappa, Rodríguez‐Violante, Mayela, Falup‐Pecurariu, Cristian, Schade, Sebastian, Petry‐Schmelzer, Jan Niklas, Metta, Vinod, Weintraub, Daniel, Deuschl, Guenther, Espay, Alberto J., Tan, Eng‐King, Bhidayasiri, Roongroj, Fung, Victor S.C., Cardoso, Francisco, Trenkwalder, Claudia, Jenner, Peter, Ray Chaudhuri, K., Dafsari, Haidar S.
Format: Journal Article
Language:English
Published: Hoboken, USA John Wiley & Sons, Inc 01.07.2023
Wiley Subscription Services, Inc
Subjects:
Basic Medicine
Clinical trials
Drug dosages
Drug therapy
Farmaceutiska vetenskaper
LEDD
Levodopa
levodopa equivalent daily dose
levodopa equivalent dose
Medical and Health Sciences
Medicin och hälsovetenskap
Medicinska och farmaceutiska grundvetenskaper
Movement disorders
Neurodegenerative diseases
Non-pharmacological intervention
Parkinson's disease
Pharmaceutical Sciences
Reviews
Systematic review
levodopa equivalent daily dose
LEDD
levodopa equivalent dose
ISSN:0885-3185, 1531-8257, 1531-8257
Online Access:Get full text
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Description
Summary:Background To compare drug regimens across clinical trials in Parkinson's disease (PD) conversion formulae between antiparkinsonian drugs have been developed. These are reported in relation to levodopa as the benchmark drug in PD pharmacotherapy as ‘levodopa equivalent dose’ (LED). Currently, the LED conversion formulae proposed in 2010 by Tomlinson et al. based on a systematic review are predominantly used. However, new drugs with established and novel mechanisms of action and novel formulations of longstanding drugs have been developed since 2010. Therefore, consensus proposals for updated LED conversion formulae are needed. Objectives To update LED conversion formulae based on a systematic review. Methods The MEDLINE, CENTRAL, and Embase databases were searched from January 2010 to July 2021. Additionally, in a standardized process according to the GRADE grid method, consensus proposals were issued for drugs with scarce data on levodopa dose equivalency. Results The systematic database search yielded 3076 articles of which 682 were eligible for inclusion in the systematic review. Based on these data and the standardized consensus process, we present proposals for LED conversion formulae for a wide range of drugs that are currently available for the pharmacotherapy of PD or are expected to be introduced soon. Conclusions The LED conversion formulae issued in this Position Paper will serve as a research tool to compare the equivalence of antiparkinsonian medication across PD study cohorts and facilitate research on the clinical efficacy of pharmacological and surgical treatments as well as other non‐pharmacological interventions in PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Bibliography:registration number
Stefanie T. Jost and Marie‐Ann Kaldenbach contributed equally.
None.
PROSPERO
Financial Disclosure/Conflict of Interest concerning the research related to the manuscript
CRD42021239664.
K. Ray Chaudhuri and Haidar S. Dafsari contributed equally.
Funding sources of the study
Correction added on 19 May 2023, after first online publication: The affiliation of K. Ray Chaudhuri has changed in this version.
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ObjectType-Evidence Based Healthcare-3
SourceType-Scholarly Journals-1
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ISSN:0885-3185
1531-8257
1531-8257
DOI:10.1002/mds.29410