Levodopa and neuropathy risk in patients with Parkinson disease: Effect of COMT inhibition

Parkinsonism Relat Disord. 2016 Jun:27:81-4. doi: 10.1016/j.parkreldis.2016.04.016. Epub 2016 Apr 20.

Abstract

Objective: Our purpose was to determine whether the use of catechol-O-methyltransferase-inhibitors (ICOMT) can reduce the risk of developing levodopa (LD)-induced neuropathy in Parkinson's disease (PD) patients.

Methods: A multicentre study of 197 PD patients was performed. 144 were exposed to LD for more than three years (LELD group); 53 simultaneously assumed Entacapone for at least eighteen months (LELD_ICOMT group).

Results: The prevalence of neuropathy in LELD patients was 19.4% whereas it was 5.7% in LELD_ICOMT group with a significant difference (p = 0.025). In LELD_ICOMT cohort the daily LD dose and serum VB12 levels were significantly higher (p < 0.0001), the serum Hcy levels were significantly lower (p = 0.001) compared to LELD group.

Conclusion: Our results suggest that ICOMT could have a protective effect on the development of LD-induced neuropathy. Their action probably occurs through the metabolic rebalancing of the one-carbon-pathway cycle and is independent of the PD duration and severity and the duration of LD intake.

Keywords: COMT inhibition; Levodopa; Parkinson's disease; Peripheral neuropathy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Antiparkinson Agents / adverse effects*
  • Catechol O-Methyltransferase Inhibitors / therapeutic use*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Levodopa / adverse effects*
  • Male
  • Middle Aged
  • Neuralgia / chemically induced*
  • Neuralgia / diagnosis
  • Neuralgia / prevention & control*
  • Parkinson Disease / diagnosis
  • Parkinson Disease / drug therapy*
  • Risk Factors
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Catechol O-Methyltransferase Inhibitors
  • Levodopa