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Impact of Pharmacotherapy on Quality of Life in Patients with Parkinson’s Disease

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Abstract

Quality of life (QoL) is a patient-reported outcome frequently included in Parkinson’s disease (PD) clinical trials as a secondary or tertiary endpoint. However, QoL is an important variable that reflects the impact of disease and treatment from the patients’ perspective. In a chronic, neurodegenerative disease such as PD, with a wide range of complex symptoms, QoL provides valuable and comprehensive information on the patients’ health status. This narrative review aims to evaluate the effect of specific PD treatments currently in use on patients’ QoL measured with the Parkinson’s Disease Questionnaire, 39-item (PDQ-39) or 8-item (PDQ-8) version. A quantification of this effect is provided by calculation of the relative change and effect size. These two parameters allow an intuitive standardized approach to the importance of change based on its magnitude. Some high-quality studies (Level I) were found for levodopa (immediate- or extended-release formulations), levodopa with added-on catechol-O-methyltransferase (COMT) inhibitors, levodopa/carbidopa gel for intestinal infusion, some dopamine agonists (ropinirole, cabergoline, pergolide), and the monoamine oxidase B (MAO-B) inhibitor safinamide. As a whole, these studies found a beneficial effect of variable magnitude, weak to moderate, on patients’ QoL. Studies with a lower level of evidence or not providing enough data to estimate relative change and effect size, including those for the apomorphine subcutaneous pump, also reported improvement of QoL, but the evidence was insufficient to confirm the effect. More high-quality studies focused on QoL are needed to determine the real impact of PD drug treatments for this important outcome.

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Conflict of interest

The authors report no conflicts of interest related to this manuscript. Pablo Martinez-Martin has received honoraria from AbbVie for participating in an epidemiological study, and from TEVA, Lundbeck, Britannia, Italfarmaco, and Abbott/AbbVie for lectures or participation in symposia. Carmen Rodriguez-Blazquez has nothing to disclose. Maria João Forjaz has nothing to disclose. Monica M. Kurtis has received honoraria from UCB for participating in an International Advisory Board.

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Authors and Affiliations

  1. National Center of Epidemiology, Carlos III Institute of Health and CIBERNED, C/ Monforte de Lemos 5, 28029, Madrid, Spain

    Pablo Martinez-Martin & Carmen Rodriguez-Blazquez

  2. National School of Public Health, Carlos III Institute of Health and REDISSEC, Madrid, Spain

    Maria João Forjaz

  3. Movement Disorders Unit, Department of Neurology, Hospital Ruber Internacional, Madrid, Spain

    Monica M. Kurtis

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  1. Pablo Martinez-Martin
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Correspondence to Pablo Martinez-Martin.

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Martinez-Martin, P., Rodriguez-Blazquez, C., Forjaz, M.J. et al. Impact of Pharmacotherapy on Quality of Life in Patients with Parkinson’s Disease. CNS Drugs 29, 397–413 (2015). https://doi.org/10.1007/s40263-015-0247-x

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