To the Editor: I have 2 concerns about the
study of Dr Marek and colleagues.1 First,
the group in this study (which is a subset of the authors' larger trial) shows
an atypically slow rate of clinical progression. The author's earlier publication2 reports a mean change in total Unified Parkinson
Disease Rating Scale (UPDRS) of 9.2 for the entire levodopa group (n = 150)
and 4.5 for the entire pramipexole group (n = 151) at 23.5 months. However,
for the subset in the current study the respective data are –3.3 for
the levodopa group and 0.9 for the pramipexole group at 22 months, and 4.0
and 4.1 at 46 months (n = 32/33). The results can therefore only be considered
relevant to patients with very slowly progressing PD.
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