2019 年 36 巻 4 号 p. 367-371
Japanese clinical practice guideline for Parkinson's disease was released in 2018. In this guideline, the importance of levodopa therapy during both early and advanced stage of PD is stressed. Further, MAO–B inhibitors became a one of first–line treatment for the early stage of PD. It is also mentioned about the characteristics of Device Aided Therapy. To state recommendations of each therapy, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was employed. The recent development of devices which is used in Deep brain stimulation enable us to control PD symptoms more precisely. From 2016, Levodopa–carbidopa intestinal gel therapy became available in Japan. We have many therapeutic options for PD treatment, however, we must start to consider the cost and benefit of each therapy in the future.
