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Initial bromocriptine did not change mortality in early, mild Parkinson's disease

Design
Randomised {allocation concealed^*}, blinded {data safety and monitoring committee},^* controlled trial with a mean 9.2 years of follow up.

Setting
UK.

Patients
782 patients with a clinical diagnosis of PD. Exclusion criteria were failure to respond to an adequate trial of dopaminergic drugs or incapacitating cognitive impairment.

Intervention
249 patients were allocated to levodopa alone, 271 to levodopa plus selegiline, and 262 to initial bromocriptine. 104 patients in the bromocriptine group were rerandomised to 1 of the other 2 treatment groups after bromocriptine was withdrawn, but all patients were analysed in the groups to which they were initially randomised.

Main outcome measures
Mortality, disability, and adverse effects.

Main results
Analysis was by intention to treat. The groups did not differ for mortality (table). At 3 years, those assigned to initial bromocriptine had worse disability scores than those assigned to levodopa alone (difference in adjusted mean Webster score 1.3, 95% CI 0.4 to 2.1). This . . . [Full text of this article]

Alberto Albanese, MD

Istituto Nazionale Neurologico Carlo Besta
Milan
Italy