Caffeine as symptomatic treatment for Parkinson disease (Café-PD): A randomized trial
Postuma RB, Anang J, Pelletier A, Joseph L, Moscovich M, Grimes D, Furtado S, Munhoz RP, Appel-Cresswell S, Moro A, Borys A, Hobson D, Lang AE
Neurology · 96 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2017-09-28 · Neurology · vol. 89 · issue 17 · pp. 1795–1803
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 135 citations · more than 99% of similar papers · 9.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 28 works
- Access
- Open access (repository copy)
- Research areas
- Coffee research and impacts · Parkinson's Disease Mechanisms and Treatments · Adenosine and Purinergic Signaling
- Keywords
- Placebo, Tolerability, Montreal Cognitive Assessment, Dyskinesia, Parkinsonism, Rating scale, Medicine, Somnolence, Internal medicine, Physical therapy, Psychology, Parkinson's disease, Adverse effect, Disease, Dementia
- MeSH
- humans, parkinson disease, caffeine, antiparkinson agents, treatment outcome, severity of illness index, follow-up studies, double-blind method, time factors, aged, middle aged, female, male
13 authors
From CA, BR, US
- Ronald B. PostumaUniversity of Ottawa; University of Calgary; Pontifícia Universidade Católica do Paraná; Toronto Western Hospital; Ottawa Hospital; MIND Research Institute; uOttawa Brain and Mind Research Institute; Djavad Mowafaghian Centre for Brain Health; University of Manitoba
- Julius B. M. AnangUniversity of Ottawa; University of Calgary; Pontifícia Universidade Católica do Paraná; Toronto Western Hospital; Ottawa Hospital; MIND Research Institute; uOttawa Brain and Mind Research Institute; Djavad Mowafaghian Centre for Brain Health; University of Manitoba
- Amélie PelletierUniversity of Ottawa; University of Calgary; Pontifícia Universidade Católica do Paraná; Toronto Western Hospital; Ottawa Hospital; MIND Research Institute; uOttawa Brain and Mind Research Institute; Djavad Mowafaghian Centre for Brain Health; University of Manitoba
- Lawrence JosephUniversity of Ottawa; University of Calgary; Pontifícia Universidade Católica do Paraná; Toronto Western Hospital; Ottawa Hospital; MIND Research Institute; uOttawa Brain and Mind Research Institute; Djavad Mowafaghian Centre for Brain Health; University of Manitoba
- Mariana MoscovichUniversity of Ottawa; University of Calgary; Pontifícia Universidade Católica do Paraná; Toronto Western Hospital; Ottawa Hospital; MIND Research Institute; uOttawa Brain and Mind Research Institute; Djavad Mowafaghian Centre for Brain Health; University of Manitoba
- David A. GrimesUniversity of Ottawa; University of Calgary; Pontifícia Universidade Católica do Paraná; Toronto Western Hospital; Ottawa Hospital; MIND Research Institute; uOttawa Brain and Mind Research Institute; Djavad Mowafaghian Centre for Brain Health; University of Manitoba
Abstract
Objective
To assess effects of caffeine on Parkinson disease (PD).
Methods
In this multicenter parallel-group controlled trial, patients with PD with 1-8 years disease duration, Hoehn & Yahr stages I-III, on stable symptomatic therapy were randomized to caffeine 200 mg BID vs matching placebo capsules for 6-18 months. The primary research question was whether objective motor scores would differ at 6 months (Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale [MDS-UPDRS]-III, Class I evidence). Secondary outcomes included safety and tolerability, motor symptoms (MDS-UPDRS-II), motor fluctuations, sleep, nonmotor symptoms (MDS-UPDRS-I), cognition (Montreal Cognitive Assessment), and quality of life.
Results
Sixty patients received caffeine and 61 placebo. Caffeine was well-tolerated with similar prevalence of side effects as placebo. There was no improvement in motor parkinsonism (the primary outcome) with caffeine treatment compared to placebo (difference between groups -0.48 [95% confidence interval -3.21 to 2.25] points on MDS-UPDRS-III). Similarly, on secondary outcomes, there was no change in motor signs or motor symptoms (MDS-UPDRS-II) at any time point, and no difference on quality of life. There was a slight improvement in somnolence over the first 6 months, which attenuated over time. There was a slight increase in dyskinesia with caffeine (MDS-UPDRS-4.1+4.2 = 0.25 points higher), and caffeine was associated with worse cognitive testing scores (average Montreal Cognitive Assessment = 0.66 [0.01, 1.32] worse than placebo).
Conclusion
Caffeine did not provide clinically important improvement of motor manifestations of PD (Class I evidence). Epidemiologic links between caffeine and lower PD risk do not appear to be explained by symptomatic effects.
Clinicaltrialsgov identifier
NCT01738178.
Classification of evidence
This study provides Class I evidence that for patients with PD, caffeine does not significantly improve motor manifestations.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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