Table 4.
Treatment by patient profile: future trends.
| TREATMENT | TREND 2030 | |||
|---|---|---|---|---|
| By 2030, the Use of This Treatment for Non-Fluctuating Patients Will… | ▼ | = | ▲ | Consensus |
| Non-pharmacological treatment alone a | 10% | 76% | 14% | Not change |
| Monotherapy | ||||
| MAOI b | 13% | 88% | 0% | Not change |
| DA c | 22% | 76% | 1% | Not change |
| Levodopa (<600 mg) | 14% | 75% | 11% | Not change |
| Anticholinergics | 35% | 65% | 0% | Undetermined |
| Levodopa (>600 mg) | 35% | 61% | 4% | Undetermined |
| MAOI d | 1% | 43% | 56% | Undetermined |
| Two-Drug Combination | ||||
| Levodopa + MAOI b | 10% | 85% | 6% | Not change |
| MAOI b + DA | 17% | 78% | 6% | Not change |
| Levodopa + DA c | 21% | 75% | 4% | Not change |
| Levodopa + COMTI | 11% | 70% | 19% | Not change |
| MAOI d +DA | 3% | 46% | 51% | Undetermined |
| Levodopa + MAOI d | 0% | 38% | 63% | Undetermined |
| Three-Drug Combination | ||||
| MAOI b + DA + levodopa | 15% | 83% | 1% | Not change |
| COMTI +DA + levodopa | 11% | 77% | 11% | Not change |
| MAOI d +DA + levodopa | 6% | 48% | 46% | Undetermined |
| Polytherapy | ||||
| ≥4 drugs | 8% | 80% | 11% | Not change |
| By 2030, the Use of This Treatment for Fluctuating Patients Will… | ▼ | = | ▲ | Consensus |
| Monotherapy | ||||
| Levodopa (<600 mg) | 27% | 72% | 1% | Not change |
| AD c | 30% | 69% | 1% | Undetermined |
| Levodopa (>600 mg) | 34% | 63% | 3% | Undetermined |
| Two-Drug Combination | ||||
| Levodopa + AD | 10% | 83% | 7% | Not change |
| Levodopa + COMTI | 1% | 79% | 20% | Not change |
| Levodopa + MAOI b | 23% | 75% | 3% | Not change |
| Levodopa + MAOI d | 1% | 35% | 63% | Undetermined |
| Three-Drug Combination | ||||
| MAOI b +DA + levodopa | 13% | 79% | 8% | Not change |
| COMTI +DA + levodopa | 1% | 79% | 20% | Not change |
| MAOI d +DA + levodopa | 0% | 41% | 59% | Undetermined |
| Polytherapy | ||||
| ≥4 drugs | 3% | 77% | 20% | Not change |
| By 2030, the Use of This Treatment in Advanced Therapy Will… | ▼ | = | ▲ | Consensus |
| DBS + other pharmacological treatments | 3% | 21% | 76% | Increase ▲ |
| Carbidopa/levodopa (enteral) + other pharmacological treatments | 7% | 25% | 68% | Undetermined |
| Apomorphine s.c. + other pharmacological treatments | 3% | 45% | 52% | Undetermined |
All panelists (n = 75) answered all questions. Percentages of panelists in each category and consensus after the second round of votes are shown. Bold % indicates that 70% consensus was achieved. COMTI: catechol-O-methyltransferase inhibitors. DA: dopaminergic agonists. DBS: deep brain stimulation. MAOI: monoaminooxidase inhibitors. s.c.: subcutaneous. a Physiotherapy, speech therapy, rehabilitation, etc. b Rasagiline, Selegiline. c Rotigotine, Ropinirole, Pramipexole. d Safinamide. ▼: it will decrease; =: it will not change; ▲: it will increase.