ABSTRACT Background In patients with motor fluctuations complicating Parkinson’s disease (PD), delays in time-to-ON with levodopa are common. This open-label study aimed to assess the effect of apomorphine on time-to-ON in PD patients with morning akinesia. Methods The safety population included 127 enrolled patients, and the full analysis set (FAS) included 88 patients. Patients completed…
Articles
Pharmacological insights into L-DOPA-induced motor fluctuations of patients with Parkinson disease
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…
Effect of levodopa-carbidopa intestinal gel on dyskinesia in advanced Parkinson’s disease patients
The purpose of this study was to assess the effect of levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension) in advanced Parkinson’s disease patients with troublesome dyskinesia.
Integrated safety of levodopa-carbidopa intestinal gel from prospective clinical trials
Continuous administration of levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension) through a percutaneous endoscopic gastrojejunostomy is a treatment option for advanced Parkinson disease (PD) patients with motor fluctuations resistant to standard oral medications. Safety data from 4 prospective studies were integrated to assess the safety of this therapy.
Apomorphine: A Potential Modifier of Amyloid Depositionin Parkinson’s Disease?
Evidence from clinical and pathological studies suggests a role for both alpha-synuclein and amyloid-beta in the pathophysiology of dementia associated with PD. Recent work demonstrated improvement in memory and reduced amyloid-beta burden in transgenic murine Alzheimer’s models given subcutaneous apomorphine. The aim of this work was to determine whether antemortem exposure to apomorphine was associated with lower levels of amyloid-beta in brain tissue in a clinicopathological study of PD.
New treatments for levodopa-induced motor complications
Levodopa (L-dopa)-induced motor complications, including motor fluctuations and dyskinesia, affect almost all patients with Parkinson’s disease (PD) at some point during the disease course, with relevant implications in global health status. Various dopaminergic and nondopaminergic pharmacological approaches as well as more invasive strategies including devices and functional surgery are available to manage such complications…
Adenosine 2A Receptor Antagonists for the Treatment of Motor Symptoms in Parkinson’s Disease
Treatment of motor fluctuations in Parkinson’s disease (PD) remains an unmet challenge. Adenosine 2A (A2A) receptors are located along the indirect pathway and represent a potential target to enhance L-3,4-dihydroxyphenylalanine (L-DOPA) antiparkinsonian action.
Zonisamide improves wearing-off in Parkinson’s disease: A randomized, double-blind study
Previously, we reported 50 mg/d zonisamide improved wearing-off without increasing dyskinesia in patients with Parkinson’s disease (PD).
Enteral Levodopa Therapy in Advanced Parkinson’s Disease with Gastroparesis
Levodopa is almost completely (~98%) absorbed in the distal part of the duodenum and the proximal jejunum. In advanced Parkinson’s disease (PD), transit of L-dopa from the stomach to the duodenum is erratic with delayed gastric emptying time,leading to fluctuations. By administering L-dopa directly into the proximal small intestine, the influence of gastric emptying rate can be negated…
Gastroretentive carbidopa/levodopa, DM-1992, for the treatment of advanced Parkinson’s disease
This study was undertaken to compare efficacy, tolerability, and pharmacokinetics of DM-1992, an extended-release formulation of carbidopa/levodopa (CD/L-dopa) with immediate-release (IR) CD/L-dopa in patients with advanced Parkinson’s disease.
