Motor Fluctuations - Articles Collection

Pharmacological insights into L-DOPA-induced motor fluctuations of patients with Parkinson disease

By Olivier Rascol

Clinical Investigation Center INSERM 1436, Department of Clinical Pharmacology and Neurosciences, University Hospital of Toulouse and University of Toulouse III, UMR Tonic 1214, NS-Park/FCRIN Network and NeuroToul COEN Center of Excellence in Neurodegeneration, Toulouse, France

The discovery 50 years ago of the spectacular efficacy of L-DOPA has revolutionized the treatment of Parkinson disease (PD), and indeed all modern Clinical Pharmacology. However, within a few years, PD patients on chronic L-DOPA therapy almost inevitably face disabling periods of reduced benefit, known as motor and non-motor “fluctuations” 1. In 2016, adequate management…

Levodopa-carbidopa intestinal gel in advanced Parkinson’s disease: Final 12-month, open-label results

By Hubert H. Fernandez MD*, David G. Standaert MD, PhD*, Robert A. Hauser MD, Anthony E. Lang MD, FRCPC, Victor S.C. Fung PhD, FRACP, Fabian Klostermann PhD, Mark F. Lew MD, Per Odin MD, PhD, Malcolm Steiger MBBS, MD, FRCP, Eduard Z. Yakupov MD, PhD, DMSc, Sylvain Chouinard MD, FRCPC, Oksana Suchowersky MD, FRCPC, FCCMG, Jordan Dubow MD, Coleen M. Hall MS, Krai Chatamra PhD, Weining Z. Robieson PhD, Janet A. Benesh BSMT and Alberto J. Espay MD, MSc

Motor complications in Parkinson’s disease (PD) are associated with long-term oral levodopa treatment and linked to pulsatile dopaminergic stimulation. L-dopa-carbidopa intestinal gel (LCIG) is delivered continuously by percutaneous endoscopic gastrojejunostomy tube (PEG-J), which reduces L-dopa-plasma–level fluctuations and can translate to reduced motor complications. We present final results of the largest international, prospective, 54-week, open-label LCIG study…

EuroInf: A Multicenter Comparative Observational Study of Apomorphine and Levodopa Infusion in Parkinson’s Disease

By Pablo Martinez-Martin MD, PhD, Prashanth Reddy MBBS, MRCP, Regina Katzenschlager MD, Angelo Antonini MD, PhD, Antoniya Todorova MD, PhD, Per Odin MD, PhD, Tove Henriksen MD, Anne Martin BSc, Daniela Calandrella MD, Alexandra Rizos MSc, Narissah Bryndum RN, Arne Glad RN, Haidar Salimi Dafsari MD, Lars Timmermann MD, Georg Ebersbach MD, Milica G. Kramberger MD, PhD, Michael Samuel MD, FRCP, Karoline Wenzel MD, Volker Tomantschger MD, Alexander Storch MD, Heinz Reichmann MD, Zvezdan Pirtosek MD, PhD, Maja Trost MD, PhD, Per Svenningsson MD, PhD, Sven Palhagen MD, Jens Volkmann MD, PhD and K. Ray Chaudhuri MD, DSc*

Subcutaneous apomorphine infusion (Apo) and intrajejunal levodopa infusion (IJLI) are two treatment options for patients with advanced Parkinson’s disease (PD) and refractory motor complications, with varying cost of treatment. There are no multicenter studies comparing the effects of the two strategies. This open-label, prospective, observational, 6-month, multicenter study compared…

Randomized Trial of Safinamide Add-On to Levo dopa in Parkinson’s Disease With Motor Fluctuations

By Rupam Borgohain DM*, J. Szasz MD, P. Stanzione MD, C. Meshram DM, M. Bhatt DM, D. Chirilineau MD, F. Stocchi MD, V. Lucini MD, R. Giuliani MD, E. Forrest, P. Rice, R. Anand MD† and for the Study 016 Investigators

Levodopa is effective for the motor symptoms of Parkinson’s disease (PD), but is associated with motor fluctuations and dyskinesia. Many patients require add-on therapy to improve motor fluctuations without exacerbating dyskinesia. The objective of this Phase III, multicenter, double-blind, placebo-controlled, parallel-group study was to evaluate the efficacy and safety of safinamide…

Long-term safety and efficacy of preladenant in subjects with fluctuating Parkinson’s disease

By Stewart A. Factor DO*, Kenneth Wolski MD, Daniel M. Togasaki MD, PhD, Susan Huyck DrPH, Marc Cantillon MD†, T.W. Ho MD‡, Robert A. Hauser MD, MBA and Emmanuelle Pourcher MD

Preladenant is a selective adenosine A2A receptor antagonist under investigation for Parkinson’s disease treatment.

Adenosine A_2A receptor antagonist istradefylline reduces daily OFF time in Parkinson’s disease

By Yoshikuni Mizuno MD*, Tomoyoshi Kondo MD and the Japanese Istradefylline Study Group

We evaluated the efficacy and safety of istradefylline, a selective adenosine A2A receptor antagonist administered as adjunctive treatment to levodopa for 12 weeks in a double-blind manner in Parkinson’s disease patients with motor complications in Japan.

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