This Issue Editorial December 28, 2021 Tanya Simuni, MD 1 ; Michael S. Okun, MD 2 Author Affiliations JAMA Neurol. 2022;79(2):119ȏ120. doi:10.1001/jamaneurol.2021.4140  Related Articles Parkinson disease (PD) is the second most common neurodegenerative disease after Alzheimer disease. The preva- lence of PD is increasing rapidly and is expected to double by 2040, to the extent that it has been called a Parkin- son pandemic. 1 The global burden of PD has also doubled in the last 20 years. 2 The economic impact of PD has been substantially and consistently increasing, specifically with regard to the advanced stage of the disease. 3 All of these factors indicate an urgent need for disease-modifying and ultimately curative and preventive therapies. Such therapies do not currently exist despite substantial efforts. On the positive side, PD has a large number of symptomatic therapies available for improvement of motor disability. Although levodopa has and remains the cri- terion standard, current oral preparations have the disadvantage of being associated with motor fluctuations and dyskinesia. As a result, levodopa adjunctive therapies have been a major target of drug development. All major classes of adjunctive therapies, such as dopamine agonists, catechol-O-methyltransferase (COMT) inhibitors, and monoamine oxidase type B (MAOȏB) inhibitors, have been found to be efficacious in reducing off time compared with placebo in well-designed studies and have been reported to be clinically useful based on an expert evidence- based systematic review. 4 However, there is paucity of data on direct head-to-head comparison of the comparative efficacy, impact for quality of life, and health economic outcomes of different classes of adjunctive therapies. 5  Full Text Access through your institution Comment Views 2,791 | Citations 0 | Altmetric 92 | Comments 1 PDF  Full Text  Share    Comment Adjunctive Therapies in Parkinson Disease—Have We Made Meaningful Progress?  Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue