Oral Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Long-term evaluation of advanced Parkinson's disease burden and clinical outcomes: results from the PROSPECT observational study (120047)

Alberto J Espay 1 , Hirohisa Watanabe 2 , Alexander Lehn 3 , Fabienne Ory-Magne 4 , Tiago A Mestre 5 , Delaram Safarpour 6 , Lars Bergmann 7 , Pavnit Kukreja 7 , Koray Onuk 7 , Jenny Waern 8 9 , Pilar Sanchez Alonso 10
  1. University of Cincinnati Gardner Neuroscience Institute, Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, Ohio, United States
  2. Department of Neurology, Fujita Health University, Nagoya, Japan
  3. Department of Neurology, Princess Alexandra Hospital, Brisbane, QLD, Australia
  4. Department of Neurology, University Hospital of Toulouse, Toulouse, France
  5. Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Canada
  6. Oregon Health and Science University School of Medicine, Portland, Oregon, United States
  7. AbbVie Inc., North Chicago, Illinois, United States
  8. AbbVie Pty Ltd, Mascot, NSW, Australia
  9. This individual has been added to this publication author by-line, with the permission of the original authors, for the express purpose of conducting the presentation at a local congress or in a local language. , He/she did not contribute to the content of the publication.
  10. Department of Neurology, Hospital U. Puerta de Hierro, Majadahonda, Spain

Aim: Evaluate long-term clinical outcomes and disease burden in people with advanced Parkinson's disease (PwP) with motor fluctuations not optimized by their current medications.

 

Methods: PROSPECT was a 24-month international, prospective, observational study of adults with idiopathic PD with insufficiently controlled motor fluctuations. Participants must have had adequate trials of oral PD medications and could not have received device-aided treatment (DAT) prior to enrollment. The primary endpoint was the "Off" time change from baseline to month 24, assessed by PD diaries.

 

Results: The study included 229 PwP with a mean (SD) age of 68.4(9.7) years, mean (SD) disease duration of 9.0(5.5) years, and mean (SD) "Off" time of 4.99(2.45) hours at baseline. Of 206 PwP with known DAT status, 55%(n=113/206) were offered DAT at different points, but most (79%, n=162/206) remained exclusively on oral PD medications during the follow-up period. Those exclusively on oral PD medications showed minimal, not clinically relevant changes in daily "Off" time from baseline to 24 months (mean [SD] -0.61[2.62] hours). No remarkable changes were observed at 24 months in HY, MDS-UPDRS part II, PDQ-39, and NMSS scores (mean [SD] change from baseline 0.2[0.7], 1.4[5.3], 1.9[9.7], and 3.2[20.9], respectively).

 

Conclusions: In this 24-month observational study, most PwP stayed on oral PD medications despite eligibility for DAT. Motor symptoms remained uncontrolled, and there were no improvements in disease burden despite care from a movement disorder specialist or clinic.