Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study

R. Cilia, J. Laguna, E. Cassani, E. Cereda, N. G. Pozzi, I. U. Isaias, M. Contin, M. Barichella, G. Pezzoli

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To investigate whether Mucuna pruriens (MP), a levodopa-containing leguminous plant growing in all tropical areas worldwide, may be used as alternative source of levodopa for indigent individuals with Parkinson disease (PD) who cannot afford long-term therapy with marketed levodopa preparations. METHODS: We investigated efficacy and safety of single-dose intake of MP powder from roasted seeds obtained without any pharmacologic processing. Eighteen patients with advanced PD received the following treatments, whose sequence was randomized: (1) dispersible levodopa at 3.5 mg/kg combined with the dopa-decarboxylase inhibitor benserazide (LD+DDCI; the reference treatment); (2) high-dose MP (MP-Hd; 17.5 mg/kg); (3) low-dose MP (MP-Ld; 12.5 mg/kg); (4) pharmaceutical preparation of LD without DDCI (LD-DDCI; 17.5 mg/kg); (5) MP plus benserazide (MP+DDCI; 3.5 mg/kg); (6) placebo. Efficacy outcomes were the change in motor response at 90 and 180 minutes and the duration of on state. Safety measures included any adverse event (AE), changes in blood pressure and heart rate, and the severity of dyskinesias. RESULTS: When compared to LD+DDCI, MP-Ld showed similar motor response with fewer dyskinesias and AEs, while MP-Hd induced greater motor improvement at 90 and 180 minutes, longer ON duration, and fewer dyskinesias. MP-Hd induced less AEs than LD+DDCI and LD-DDCI. No differences in cardiovascular response were recorded. CONCLUSION: Single-dose MP intake met all noninferiority efficacy and safety outcome measures in comparison to dispersible levodopa/benserazide. Clinical effects of high-dose MP were similar to levodopa alone at the same dose, with a more favorable tolerability profile. CLINICALTRIALSGOV IDENTIFIER: NCT02680977.
Original languageEnglish
Pages (from-to)432-438
Number of pages7
JournalNeurology
Volume89
Issue number5
DOIs
Publication statusPublished - Aug 1 2017

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Keywords

  • Antiparkinson Agents/adverse effects/pharmacokinetics/therapeutic use
  • Benserazide/adverse effects/therapeutic use
  • Blood Pressure/drug effects
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Dyskinesia, Drug-Induced
  • Female
  • Heart Rate/drug effects
  • Humans
  • Levodopa/adverse effects/pharmacokinetics/therapeutic use
  • Male
  • Middle Aged
  • Motor Activity/drug effects
  • Mucuna
  • Parkinson Disease/drug therapy
  • Phytotherapy/adverse effects
  • Powders
  • Seeds
  • Treatment Outcome

Cite this

Cilia, R., Laguna, J., Cassani, E., Cereda, E., Pozzi, N. G., Isaias, I. U., Contin, M., Barichella, M., & Pezzoli, G. (2017). Mucuna pruriens in Parkinson disease: A double-blind, randomized, controlled, crossover study. Neurology, 89(5), 432-438. https://doi.org/10.1212/WNL.0000000000004175 [doi]