Transdermal nicotine treatment fails to slow progression of early Parkinson's disease

The lead author of this study, “Transdermal Nicotine Treatment and Progression of Early Parkinson’s Disease,” is Wolfgang H. Oertel, M.D.

Based on the data from Epidemiologic studies, smokers have a lower incidence of Parkinson’s disease. It has been hypothesized that Nicotine slows the progression of early Parkinson’s disease.

Researchers randomly assigned patients with Parkinson’s disease who were diagnosed within 18 months (Hoehn and Yahr disease stage less than or equal to 2, therapy naïve and not requiring dopaminergic therapy, to transdermal Nicotine or placebo.)

The primary endpoint was a change in the Unified Parkinson’s Disease Rating Scale parts I–III (Total UPDRS) score between baseline and 60 weeks.

Summary of important clinical points includes:

• Among 163 participants, 101 were assessed for the primary endpoint. In the placebo versus nicotine group, the mean worsening of Total UPDRS was 3.5 versus 6.0, respectively.

• For the first secondary endpoint, in the placebo versus nicotine group, analysis of 138 participants showed a mean worsening of 5.4 versus 9.1

• The causes of Dropout were early treatment discontinuation and adverse events.

• At the site of patch applications, Cutaneous adverse effects were common.

• During participation, 34.6% of participants initiated dopaminergic therapy.

They noted one-year transdermal nicotine treatment did not slow the progression of early Parkinson’s disease.

As acknowledged, the study was funded by the Michael J. Fox Foundation for Parkinson’s Research and others.