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To the Editor: In their article about neuroprotection in Parkinson disease (PD), Drs Schapira and Olanow¹ briefly discussed our phase 2 study of coenzyme Q₁₀ in early PD.² We believe that in their statement that "activity of daily living scores improved significantly following introduction of the drug, raising the possibility that an unanticipated symptomatic effect might also have confounded interpretation," the authors have overstated the significance of one item in the results.

The prespecified, primary response variable for our study was the change in the total score on the Unified Parkinson Disease Rating Scale (UPDRS) from the baseline visit to last visit. Our primary analysis showed a positive but nonsignificant trend (P = .09) for coenzyme Q₁₀ to attenuate the worsening on the UPDRS, and in a prespecified secondary analysis, the highest dosage (1200 mg/d) was the most effective compared with placebo (P = .04, uncorrected for multiple . . . [Full Text of this Article]

Clifford W. Shults, MD
cshults@ucsd.edu

Richard Haas, MBChir
Department of Neurosciences
University of California, San Diego
La Jolla

David Oakes, PhD
Department of Statistics and Computational Biology

Karl Kieburtz, MD
Clinical Trials Coordination Center

Sandra Plumb, BS; Ira Shoulson, MD
Department of Neurology
University of Rochester
Rochester, NY

M. Flint Beal, MD
Neurochemistry Laboratory
Weill Medical College of Cornell University
New York, NY

Jorge Juncos, MD
Department of Neurology
Emory University School of Medicine
Atlanta, Ga

John Nutt, MD
Department of Neurology
Oregon Health and Science University
Portland

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