The levodopa dose-sparing capacity of pergolide compared with that of bromocriptine in an open-label, crossover study

The levodopa dose-sparing capacity of pergolide and bromocriptine, along with the maximum ability to improve activity of daily living and motor scores, were compared in 33 patients with idiopathic Parkinson's disease (Hoehn-Yahr stage 2-4) in a 24-week, open-label, crossover study. Patients received one dopamine agonist for 12 weeks and then were crossed over to the other for 12 weeks (8 weeks, titration; 4 weeks, steady state in each period). The maximum doses allowed were pergolide 5 mg/day and bromocriptine 50 mg/day. As patients' clinical response to a dopamine agonist increased, the levodopa dose was decreased. Twenty-seven patients completed the study. No serious adverse events or clinically significant changes in vital signs or laboratory tests were observed. The mean doses of bromocriptine and pergolide at the end of titration were 21.7 +/- 5.6 mg (bromocriptine data for the two groups combined) and 3.6 +/- 1.1 mg (Pergolide data for the two groups combined), respectively. The mean levodopa dose was reduced 8.3% with bromocriptine as the first agent and increased 28.0% with bromocriptine as the second agent. The mean levodopa dose was reduced 31.4% with pergolide as the first agent and 15.5% with pergolide as the second agent. Levodopa could not be discontinued in any of the patients. Statistically significant levodopa dose-sparing capacity and considerable clinical benefit were achieved with both agonists; however, the results were more favorable with pergolide.