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Levetiracetam for levodopa-induced dyskinesia in Parkinson’s disease: a randomized, double-blind, placebo-controlled trial

  • Movement Disorders - Original Article
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Abstract

The aim of this study was to assess the efficacy, safety and tolerability of the antiepileptic compound levetiracetam (LEV) for the treatment of levodopa-induced dyskinesia (LID) in Parkinson’s disease (PD). We thus performed a randomized, double-blind, placebo-controlled, parallel-group pilot study in PD patients with moderate-to-severe LID on stable dopaminergic therapy. Placebo or LEV was administered twice daily (titrated from 250 to 2,000 mg/day) as add-on therapy. Subjects underwent evaluation of the unified-PD-rating scale (UPDRS) and the modified abnormal involuntary movement scale (AIMS). The primary outcome variable was the change of the AIMS score between baseline and end-of-treatment visit. Secondary variables included total UPDRS score and response to levodopa challenge. Of 32 randomized patients (mean age 65.2 years, 62.5% women), 17 received LEV and 15 placebo. After 11 weeks of treatment, mean changes of the modified AIMS from baseline were −1.5 (−26%) for LEV (p = 0.332) and +0.9 (+13%) for placebo (p = 0.588) without significant differences between groups. Mean changes of the UPDRS item 32/33 sum score from baseline showed significant improvement of dyskinesia in the LEV group [−1.0 (−20%); p = 0.012], but not in the placebo group [−0.4 (−8%); p = 0.306]. Treatment had no effects on UPDRS motor score or levodopa response. Frequency and quality of adverse events were similar in both treatment groups. Together, LEV showed only mild antidyskinetic effects without worsening of Parkinsonian symptoms or compromising levodopa efficacy. LEV was well tolerated in doses up to 2,000 mg/day. Further large controlled studies are warranted to evaluate the impact of LEV on LID in PD patients.

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Acknowledgments

The study was supported by an unrestricted grant from UCB Pharma GmbH, Kerpen, Germany, to the Dresden University of Technology and the research funds of the Medical Faculty Carl Gustav Carus at the Dresden University of Technology. Study drug and matched placebo were provided by UCB Pharma GmbH, Kerpen, Germany. All authors had full access to the study data and the corresponding author had a final responsibility for the decision to submit the study for publication.

Conflict of interest

The study was sponsored by UCB Pharma GmbH, Kerpen, Germany, by an unrestricted research grant. MW has received lecture honoraria from the sponsor. ML, KS, US and CS have nothing to disclose. HR has received lecture fees and is part of a national and international UCB advisory board. XG has nothing to disclosure. JS has received honoraria for presentations and advisory board meetings from the sponsor. AS has received research grants, lecture fees and honoraria for advisory board meetings from the sponsor.

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Authors and Affiliations

  1. Department of Neurology, Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany

    Martin Wolz, Matthias Löhle, Christine Schneider, Heinz Reichmann & Alexander Storch

  2. Department of Neurology, University of Leipzig, 04103, Leipzig, Germany

    Karl Strecker & Johannes Schwarz

  3. Coordination Center for Clinical Trials, Dresden University of Technology, 01307, Dresden, Germany

    Uta Schwanebeck & Xina Grählert

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  1. Martin Wolz
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  2. Matthias Löhle
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  5. Christine Schneider
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  9. Alexander Storch
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Correspondence to Alexander Storch.

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Wolz, M., Löhle, M., Strecker, K. et al. Levetiracetam for levodopa-induced dyskinesia in Parkinson’s disease: a randomized, double-blind, placebo-controlled trial. J Neural Transm 117, 1279–1286 (2010). https://doi.org/10.1007/s00702-010-0472-x

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