Comparative efficacy of two oral sustained-release preparations of L-dopa in fluctuating Parkinson's disease. Preliminary findings in 20 patients

  • B. Kleedorfer
  • W. Poewe
Short Communication


20 patients with Parkinson's disease and a fluctuating response to chronic treatment with conventional L-dopa preparations participated in an open randomized trial comparing two sustained-release L-dopa preparations (Madopar HBS, Sinemet CR4). While a majority (15 patients, 7 on Madopar HBS and 8 on Sinemet CR4) showed a favourable response after 2 months of slow-release L-dopa treatment the clinical benefit remained stable in only 2 patients on Madopar HBS and 3 patients on Sinemet CR4 over the entire follow-up period of 12 months. Reasons for treatment failure were increased peak-dose or biphasic dyskinesias or prolonged “off”-periods. This preliminary study failed to demonstrate clinically significant advantages of one slow-release principle over the other.

Key words

Parkinson's disease motor fluctuations oral sustained release L-dopa preparations 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Cedarbaum JM (1989) The promise and limitations of controlled-release oral levodopa administration. Clin Neuropharmacol 12: 147–166Google Scholar
  2. Cedarbaum JM, Breck L, Kutt H, McDowell FH (1987) Controlled-release levodopa/carbidopa. II. Sinemet CR4 treatment of response fluctuations in Parkinson's disease. Neurology 37: 1607–1612Google Scholar
  3. Cedarbaum JM, Hoey M, McDowell FH (1989) A double-blind crossover comparison of Sinemet CR4 and standard Sinemet 25/100 in patients with Parkinson's disease and fluctuating motor performance. J Neurol Neurosurg Psychiatry 52: 207–212Google Scholar
  4. Chouza C, Romero S, Medina O, Aljanati R, Scarmelli A, Camano JL, Panizza VG (1987) Substitution of standard Madopar by Madopar HBS in Parkinsonians with fluctuations. Eur Neurol 27 [Suppl 1]: 59–67Google Scholar
  5. Crevoisier C, Hoevels B, Zuercher G, Da Prada M (1987) Bioavailability of L-dopa after Madopar HBS administration in healthy volunteers. Eur Neurol 27 [Suppl 1]: 36–47Google Scholar
  6. Erni W, Held K (1987) Madopar HBS-a controlled-release dosage from. Eur Neurol 27 [Suppl 1]: 21–27Google Scholar
  7. Goetz CG, Tanner CM, Klawans HL, Shannon KM, Caroll VS (1987) Parkinson's disease and motor fluctuations: long acting carbidopa/levodopa (CR4 Sinemet). Neurology 37: 875–878Google Scholar
  8. Goetz CG, Tanner MD, Shannon KM, Caroll V, Klawans HL, Carvey PM, Gilley D (1988) Controlled-release carbidopa/levodopa (Sinemet CR4) in Parkinson's disease patients with and without motor fluctuations. Neurology 38: 1143–1146Google Scholar
  9. Marion MH, Stocchi F, Malcolm SL, Quinn NP, Jenner P, Marsden CD (1987) Single dose studies of a slow-release preparation of Levodopa and Benserazide (Madopar HBS) in Parkinson's disease. Eur Neurol 27 [Suppl 1]: 54–58Google Scholar
  10. Marsden CD, Parkes JD, Quinn N (1982) Fluctuations of disability in Parkinson's disease: clinical aspects. In: Marsden CD, Fahn S (eds) Movement disorders. Butterworth Scientific, London, pp 96–122Google Scholar
  11. Poewe WH, Lees AJ, Stern GM (1986) Treatment of motorfluctuations in Parkinson's disease with an oral sustained-release preparation of L-dopa: clinical and pharmacological observations. Clin Neuropharmacol 9: 430–439Google Scholar
  12. Poewe W, Kleedorfer B, Gerstenbrand F (1989) Therapeutische Erfahrungen mit einem “slow-release” Praeparat von L-dopa (Madopar HBS) bei Patienten mit fortgeschrittener Parkinson-Krankheit. Nervenarzt 60: 294–298Google Scholar
  13. Quinn N, Parkes JD, Marsden CD (1984) Control of on/off phenomena by continuous intravenous infusion of levodopa. Neurology 34: 1131–1136Google Scholar
  14. Sage JI, Mark MH (1988) Comparison of controlled-release Sinemet (CR4) and standard Sinemet (25 mg/100 mg) in advanced Parkinson's disease: a double-blind, cross-over study. Clin Neuropharmacol 11: 164–179Google Scholar
  15. Yeh KC, August IF, Bush DF, Lasseter KC, Musson DG, Schwartz S, Smith ME, Titus DC (1989) Pharmacokinetics and bioavailability of Sinemet CR: a summary of human studies. Neurology 39 [Suppl 2]: 25–37Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • B. Kleedorfer
    • 1
  • W. Poewe
    • 1
  1. 1.Universitätsklinik für NeurologieInnsbruckAustria

Personalised recommendations