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

Jost, Stefanie T. ; Kaldenbach, Marie Ann ; Antonini, Angelo ; Martinez-Martin, Pablo ; Timmermann, Lars ; Odin, Per LU orcid ; Katzenschlager, Regina ; Borgohain, Rupam ; Fasano, Alfonso and Stocchi, Fabrizio , et al. (2023) In Movement Disorders 38(7). p.1236-1252
Abstract

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... (More)

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.

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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
LEDD, levodopa equivalent daily dose, levodopa equivalent dose
in
Movement Disorders
volume
38
issue
7
pages
1236 - 1252
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:37147135
  • scopus:85158833251
ISSN
0885-3185
DOI
10.1002/mds.29410
language
English
LU publication?
yes
id
c5047c00-5e31-4fb5-aefc-713943c34cf3
date added to LUP
2023-08-15 15:12:39
date last changed
2024-04-20 01:41:30
@article{c5047c00-5e31-4fb5-aefc-713943c34cf3,
  abstract     = {{<p>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.</p>}},
  author       = {{Jost, Stefanie T. and Kaldenbach, Marie Ann and Antonini, Angelo and Martinez-Martin, Pablo and Timmermann, Lars and Odin, Per and Katzenschlager, Regina and Borgohain, Rupam and Fasano, Alfonso and Stocchi, Fabrizio and Hattori, Nobutaka and Kukkle, Prashanth Lingappa and Rodríguez-Violante, Mayela and Falup-Pecurariu, Cristian and Schade, Sebastian and Petry-Schmelzer, Jan Niklas and Metta, Vinod and Weintraub, Daniel and Deuschl, Guenther and Espay, Alberto J. and Tan, Eng King and Bhidayasiri, Roongroj and Fung, Victor S.C. and Cardoso, Francisco and Trenkwalder, Claudia and Jenner, Peter and Ray Chaudhuri, K. and Dafsari, Haidar S.}},
  issn         = {{0885-3185}},
  keywords     = {{LEDD; levodopa equivalent daily dose; levodopa equivalent dose}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1236--1252}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Movement Disorders}},
  title        = {{Levodopa Dose Equivalency in Parkinson's Disease : Updated Systematic Review and Proposals}},
  url          = {{http://dx.doi.org/10.1002/mds.29410}},
  doi          = {{10.1002/mds.29410}},
  volume       = {{38}},
  year         = {{2023}},
}