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…
levodopa
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).
Two-year, randomized, controlled study of safinamide as add-on to levodopa in mid to late Parkinson’s disease
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
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…
Adenosine A2A receptor antagonist istradefylline reduces daily OFF time in Parkinson’s disease
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.