Abstracts for these reports are published in Parkinsonism and Related Disorders, Volume 5 Supplement, 1999. Designations below refer to the poster numbers.

1. A five-year double-blind study with cabergoline versus levodopa
UK Rinne and the PKDS009 Collaborative Study Group
P-TU-133

Early use of cabergoline with or without levodopa delays the onset of dyskinesias and other motor complications, according to this study.

Four-hundred nineteen de novo patients were randomized to receive either levodopa or cabergoline, with open-label levodopa supplementation allowed as needed for optimal symptom control. The primary endpoint was development of motor complications. Sixty percent of patients completed the study, with approximately equal numbers in each arm. Median daily doses at study end were 783 mg levodopa, or 3 mg cabergoline plus 431 mg levodopa. Motor complications (primarily end-of-dose failures) were observed in 34% of levodopa patients, and 22% of cabergoline patients. Dyskinesias were seen in 21% of levodopa patients, and 9.5% of cabergoline patients. Levodopa produced a slight, but statistically significant, improvement in UPDRS motor scores. The authors conclude, "Cabergoline demonstrates a reduced risk of motor complications and may be recommended either as monotherapy, or in combination with L-dopa, in newly diagnosed Parkinsonian patients."

2. Comparative study of the effect of pergolide and cabergoline on nocturnal disabilities in Parkinson's disease: A single-blind study
KR Chaudhauri, T Gathani, C Agapito, C Clough
P-TU-081

The long-acting dopamine agonist cabergoline is superior to the shorter-acting pergolide for treatment of nocturnal disabilities, according to this study. Patients with dopa-resistant nocturnal disabilities (dyskinesias, nocturnal awakening, early-morning dystonia, or dystonic pain) were treated with an evening dose of either cabergoline (33 patients, mean dose 2.6 mg) or pergolide (28 patients, mean dose 2 mg). Evaluations of sleep diaries, video, and clinical global impression were performed by a blinded observer at three-month intervals. Cabergoline significantly reduced dystonic pain, nocturnal awakening, and early-morning dystonia comparedto pergolide, while both reduced dyskinesias somewhat. Adverse effects, tolerability, and compliance were better for cabergoline.

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