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Initial bromocriptine did not change mortality in early, mild Parkinson's disease
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 QUESTION: In patients with early, mild Parkinson's disease (PD), does the long term effectiveness of levodopa alone differ from that of levodopa plus selegiline or initial bromocriptine monotherapy?

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104 patients in the bromocriptine group were rerandomised to 1 of the other 2 treatment groups after bromocriptine was withdrawn, but all patients were analysed in the groups to which they were initially randomised.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. …

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