Parkinson's disease-associated dyskinesia in countries with low access to levodopa-sparing regimens

TY - JOUR

T1 - Parkinson's disease-associated dyskinesia in countries with low access to levodopa-sparing regimens

AU - Reddy, Sumanth P.

AU - Socal, Mariana P.

AU - Rieder, Carlos Roberto de Mello

AU - Schumacher-Schuh, Artur Francisco

N1 - Funding Information: Sumanth P. Reddy BBA sumanth.reddy@utsouthwestern.edu Mariana P. Socal MD, PhD, MPP, MSc Carlos Roberto de Mello Rieder MD, PhD Artur Francisco Schumacher‐Schuh MD, PhD Department of Global Health University of Texas Southwestern Medical Center Dallas Texas USA Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA Departamento de Neurologia Universidade Federal de Ciências da Saúde de Porto Alegre Porto Alegre RS Brazil Departamento de Farmacologia Universidade Federal do Rio Grande do Sul Porto Alegre RS Brazil Serviço de Neurologia Hospital de Clínicas de Porto Alegre Porto Alegre RS Brazil Brazil dyskinesia health policy levodopa Parkinson's disease Financiadora de Estudos e Projetos Michael J. Fox Foundation for Parkinson's Research National Institute for Neurologic Disorders and Stroke Relevant conflicts of interest/financial disclosures: The authors have no conflicts of interest to disclose. Funding agencies: BioFind is sponsored by the Michael J. Fox Foundation for Parkinson's Research (MJFF) with support from the National Institute for Neurologic Disorders and Stroke (NINDS). The Brazilian cohort was supported by Financiadora de Estudos e Projetos (FIPE‐HCPA). Furthermore, they found that patients who do experience severe dyskinesias typically respond well to adjustments in dopaminergic therapy and/or the addition of amantadine. In their recent viewpoint publication “Should There Be Less Emphasis on Levodopa‐Induced Dyskinesia in Parkinson's Disease,” Chaudhuri et al presented convincing evidence to support the notion that the majority of patients with levodopa‐induced dyskinesias do not find these symptoms to be troublesome. Although the authors focused on evidence from patients in developed countries, which are more likely to use agents other than levodopa, they acknowledged that the global burden of dyskinesia may remain a significant issue, especially “in countries where longer‐acting therapies or levodopa sparing options may not be available.” In this cohort more than 50% of patients were on dopamine agonists, and approximately 40% experienced dyskinesias (Table ). However, none of these patients endorsed symptoms of “troublesome dyskinesias” according to the criteria proposed by Chaudhuri et al based on the ALTHEA study (dyskinesias >75% of the waking day and with severe impact on daily function; Table ). In an attempt to examine the hypothesis raised by the authors regarding the association between severe dyskinesia and the availability of agents other than levodopa, we first reviewed the results from the United States–based BioFIND cohort.

PY - 2019/12/1

Y1 - 2019/12/1

KW - Brazil

KW - Parkinson's disease

KW - dyskinesia

KW - health policy

KW - levodopa

UR - http://www.scopus.com/inward/record.url?scp=85076714641&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85076714641&partnerID=8YFLogxK

U2 - 10.1002/mds.27891

DO - 10.1002/mds.27891

M3 - Letter

C2 - 31845765

AN - SCOPUS:85076714641

VL - 34

SP - 1929

EP - 1930

JO - Movement Disorders

JF - Movement Disorders

SN - 0885-3185

IS - 12

ER -