What are the risk factors of wear off in the treatment of Parkinson’s disease?

Wear off happens when motor symptoms or non motor symptoms reemerge during the interval of Parkinson’s disease treatment. Often time it occurs in the treatment of levodopa.

It is estimated that 40% Parkinson’s disease patients will experience wear off after 4-5 years treatment of Levodopa and almost all patients will go through wear off after 10 years of treatment.

A recent study published on Cureus has discovered serval risk factors for wear off:

• Age. The study results indicate that the younger people are while being diagnosed with PD, the more chance these patient would experience wear off after treatment

• Age at presentation of symptoms.

• Duration of disease

• The durations of anti-parkinsonian treatment

• The duration of levodopa treatment

• The doses of levodopa. Another risky factor that affect wear off is the doses of levodopa. The higher doses levodopa is taken, the more likely PD patients would develop wear off.

• The use of dopamine agonists. Last but not least, the use of dopamine agonists such as catechol-O-methyl transferase (COMT) inhibitors would increase the probability of developing wear off.

Raja K, Ramrakhia S, Dev K, et al. (September 30, 2020) The Risk Factors for the Wearing-Off Phenomenon in Parkinson's Disease. Cureus 12(9): e10729. DOI 10.7759/cureus.10729