Articles

Apomorphine Therapy: The Hazard of Left Over Needles

By Bertrand Degos MD, PhD*, Sophie Aix CRNP, Emmanuel Roze MD, PhD and Marie Vidailhet MD

A 55-year-old patient with Parkinson’s disease (PD) was seen for a shoulder abscess. This abscess was related to the presence of a subcutaneous needle that was disconnected from the tubing used for continuous apomorphine therapy…

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…

Clinical spectrum of levodopa-induced complications

By Camila Catherine Aquino MD, MSc and Susan H. Fox MRCP (UK), PhD*

The first years of Parkinson disease (PD) treatment are marked by good and sustained responses to dopaminergic therapy. With disease progression and longer exposure to levodopa (L-dopa), patients develop a range of L-dopa–induced complications that include motor and non-motor symptoms…

Novel formulations and modes of delivery of levodopa

By Werner Poewe MD* and Angelo Antonini MD, PhD

Ever since its early clinical use in the 1960s, levodopa has remained the gold standard of symptomatic efficacy in the drug treatment of Parkinson’s disease (PD). Motor response fluctuations and drug-induced dyskinesias seriously compromise the unparalleled symptomatic efficacy of L-dopa during long-term treatment…

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…

Cost of deep brain stimulation for the treatment of Parkinson’s disease by surgical stimulation sites

By Kevin T. Stroupe PhD*, Frances M. Weaver PhD, Lishan Cao MS, Dolores Ippolito MPH, Brandon R. Barton MD, MS, Inger E. Burnett-Zeigler PhD, Robert G. Holloway MD, MPH, Barbara G. Vickrey MD, MPH, Tanya Simuni MD and Kenneth A. Follett MD, PhD

Objective: To assess costs and effectiveness of deep brain stimulation (DBS) of the internal globus pallidum (GPi) versus subthalamic nucleus (STN) from the provider and societal perspectives for Parkinson’s disease (PD) patients in a multicenter randomized trial.

Two-year, randomized, controlled study of safinamide as add-on to levodopa in mid to late Parkinson’s disease

By Rupam Borgohain DM*, Jozsef Szasz MD, Paolo Stanzione MD, Chandrashekhar Meshram DM, Mohit H. Bhatt DM, Dana Chirilineau MD, Fabrizio Stocchi MD, Valentina Lucini MD, Rodolfo Giuliani MD, Emma Forrest PhD, Patricia Rice PhD, Ravi Anand MD and the Study 018 Investigators

In a 6-month double-blind, placebo-controlled study of Parkinson’s disease patients with motor fluctuations, safinamide 50 and 100 mg/d significantly increased ON-time without increasing dyskinesia. Further long-term safinamide use in these patients was evaluated over an additional 18 months. Patients continued on their randomized placebo, 50, or 100 mg/d safinamide. The primary endpoint was change in Dyskinesia Rating Scale total score during ON-time over 24 months…

Double-blind study of the actively transported levodopa prodrug XP21279 in Parkinson’s disease

By Peter A. LeWitt MD, MMSc*, F. Jacob Huff MD, Robert A. Hauser MD, MBA, Dan Chen MD, PhD, Dmitri Lissin MD, Katie Zomorodi PhD and Kenneth C. Cundy PhD

The objective of this study was to assess the efficacy, safety, and pharmacokinetics of XP21279-carbidopa in patients with Parkinson’s disease who experience motor fluctuations compared with immediate-release carbidopa-levodopa tablets. XP21279 is a levodopa prodrug that is actively absorbed by high-capacity nutrient transporters expressed throughout the gastrointestinal tract and then rapidly converted to levodopa by carboxylesterases. XP21279-carbidopa sustained-release bilayer tablets were developed to overcome pharmacokinetic limitations of levodopa by providing more continuous exposure…

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.

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