Neurology and Therapy (Feb 2024)

Dyskinesia and Pain in Advanced Parkinson’s Disease: Post Hoc Analysis from the Phase 3b, Open-Label, Randomized DYSCOVER Study

  • Eric Freire-Alvarez,
  • Paola Vanni,
  • Egon Kurča,
  • Lydia Lopez-Manzanares,
  • Norbert Kovács,
  • Cleanthe Spanaki,
  • Tianming Gao,
  • Lars Bergmann,
  • Olga Sánchez-Soliño

DOI
https://doi.org/10.1007/s40120-024-00583-z
Journal volume & issue
Vol. 13, no. 2
pp. 437 – 447

Abstract

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Abstract Introduction The DYSCOVER study was a phase 3b, open-label, randomized trial (NCT02799381) that evaluated levodopa-carbidopa intestinal gel (LCIG) versus optimized medical treatment (OMT) in patients with Parkinson’s disease (PD) and a high burden of dyskinesia at baseline (defined as Unified Dyskinesia Rating Scale [UDysRS] total score ≥ 30). At week 12, patients receiving LCIG versus OMT experienced significant improvements in dyskinesia, pain, and health-related outcomes. The objective of this analysis was to examine correlations between dyskinesia, pain, and health-related outcomes in PD. Methods This post hoc analysis assessed correlations between UDysRS, King’s Parkinson’s Disease Pain Scale (KPPS), 8-item Parkinson’s Disease Questionnaire (PDQ-8), Unified Parkinson’s Disease Rating Scale part II, Clinical Global Impression of Severity (CGI-S) or Change (CGI-C), and “On” time without troublesome dyskinesia at baseline and after 12 weeks of LCIG or OMT. Correlations were assessed by Pearson correlation coefficients (categorization: weak, r = 0.20–0.39; moderate, r = 0.40–0.59; strong, r ≥ 0.60). Results Among 61 patients, moderate-to-strong positive and significant correlations were observed between UDysRS and KPPS scores (baseline, r = 0.47; week 12 change from baseline [CFB], r = 0.63; all p < 0.001). UDysRS and KPPS scores had moderate-to-strong positive and highly significant correlations with PDQ-8 scores (baseline, r = 0.45 and 0.46, respectively; CFB, r = 0.54 and 0.64, respectively; all p < 0.001). Moderate positive and significant correlations were observed between UDysRS and CGI-S/CGI-C scores (baseline, r = 0.41; CFB, r = 0.47; all p < 0.001). Conclusions In patients with high dyskinesia burden, positive correlations were observed between dyskinesia, pain, and health-related quality of life (HRQoL) at baseline. Improvements in dyskinesia and pain were associated with improvements in HRQoL, demonstrating the clinical burden of troublesome dyskinesia. Trial Registration Number Clinicaltrials.gov identifier NCT02799381.

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