Clinical efficacy of istradefylline versus rTMS on Parkinson’s disease in a randomized clinical trial

AbstractObjective:To compare the efficacy of istradefylline (20 mg/day, 40 mg/day) and repetitive transcranial magnetic stimulation (rTMS) (1 Hz, 10 Hz) as an adjunct therapy to levodopa in the treatment of Parkinson’s disease (PD).Methods:A total of 132 PD patients from China were randomly assigned to receive 20 mg/day istradefylline plus sham-rTMS (Group I), 40 mg/day istradefylline plus sham-rTMS (Group II), placebo plus 1 Hz rTMS (Group III) and placebo plus 10 Hz rTMS (Group IV) for 12 weeks. Unified Parkinson’s Disease Rating Scale (UPDRS) part III score was the primary outcome. Clinical Global Impression–Global Improvement (CGI-I) was the secondary outcome. The change in daily off time in Groups I and II was also recorded.Results:After 12 weeks of treatment, the changes in UPDRS part III score were −6.05, −6.39, −5.91 and −6.46 for Groups I, II, III and IV, respectively, and the difference was not significant. The difference in CGI-I among the four groups was not significant. The daily off time was...