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Diagnosis and Management of Levodopa Response Fluctuations in Parkinson’s Disease

Ket Patel

An exclusive one to one interview with Professor Werner Poewe, MD, PhD, Innsbruck Medical University, Innsbruck, Austria

This interview was supported by an independent educational grant by Bial

HOW TO OBTAIN CME CREDITS

Participants requesting CME credits are required to complete the online evaluation form on the EACIC website www.eacic.eu.

Please follow the below steps to receive your CME Certificate.

  1. Go to the EACIC website www.eacic.eu
  2. Click on “CLAIM YOUR CME CREDITS”
  3. Choose the option “I AM ALREADY REGISTERED” or “I AM NOT REGISTERED”
  4. The Event Code for this event is ORUEN2020
  5. Log on or register
  6. Complete the online evaluation form
  7. Press “save”
  8. Your CME certificate will be automatically emailed to the address provided

The deadline to complete the evaluation form is 30 August 2020.

 

References

  1. Ray CK, Poewe W, Brooks D. Motor and Nonmotor Complications of Levodopa: Phenomenology, Risk Factors, and Imaging Features. Mov Disord. 2018;33(6):909-919.
  2. WebMD website. What Are Parkinson’s Disease Motor Fluctuations? https://www.webmd.com/parkinsons-disease/motor-fluctuations#1. Accessed 14 November, 2019.
  3. PD Med Collaborative Group, Gray R, Ives N, et al. Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson’s disease (PD MED): a large, open-label, pragmatic randomised trial. Lancet. 2014;384(9949):1196-1205.
  4. Stowe R, Ives N, Clarke C, et al. Dopamine agonist therapy in early Parkinson’s disease. Cochrane Database Syst Rev. 2008;Issue 2. Art. No.: CD006564. DOI: 10.1002/14651858.CD006564.pub2.
  5. Zappia M, Oliveri R, Montesanti R, et al. Loss of long-duration response to levodopa over time in PD: implications for wearing off. Neurology. 1999;52(4):763-767.
  6. Anderson E, Nutt J. The long-duration response to levodopa: phenomenology, potential mechanisms and clinical implications. Parkinsonism Relat Disord. 2011;17(8):587-592.
  7. Fahn, S., Oakes D, et al. Levodopa and the progression of Parkinson’s disease. New Engl J Med. 2004;351(24):2498-2508.
  8. Antonini A, Moro E, Godeiro C, Reichmann H. Medical and Surgical Management of Advanced Parkinson’s Disease. Mov Disord. 2018;33(6):900-908.
  9. Espay A, Pagan F, Walter B, et al. Optimizing extended-release carbidopa/levodopa in Parkinson disease. Neurol Clin Pract. 2017;7(1):86-93.
  10. Youdim M, Edmondson D, Tipton K. The therapeutic potential of monoamine oxidase inhibitors. Nat Rev Neurosci. 2006;7(4):295-309.
  11. Rascol, O., Brooks D, et al. Rasagiline as an adjunct to levodopa in patients with Parkinson’s disease and motor fluctuations (LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily, study): a randomised, double-blind, parallel-group trial. Lancet. 2005;365(9463):947-954.
  12. Reichmann H, Emre M. Optimizing levodopa therapy to treat wearing-off symptoms in Parkinson’s disease: focus on levodopa/carbidopa/entacapone. Expert Rev Neurother. 2012;12(2):119-131.
  13. Brooks D. Optimizing levodopa therapy for Parkinson’s disease with levodopa/carbidopa/entacapone: implications from a clinical and patient perspective. Neuropsychiatr Dis Treat. 2008;4(1):39-47.
  14. Fox, SH., Katzenschlager R, et al. International Parkinson and movement disorder society evidence-based medicine review: Update on treatments for the motor symptoms of Parkinson’s disease. Mov Disord. 2018;33(8):1248-1266.
  15. Ferreira J, Lees A, Rocha J, Poewe W, Rascol O, Soares-da-Silva P. Opicapone as an adjunct to levodopa in patients with Parkinson’s disease and end-of-dose motor fluctuations: a randomised, double-blind, controlled trial. Lancet Neurol. 2016;15(2):154-165.
  16. Kianirad Y, Simuni T. Novel Approaches to Optimization of Levodopa Therapy for Parkinson’s Disease. Curr Neurol Neurosci Rep. 2016;16:34.
  17. Nutt J. Continuous levodopa infusion is better–for now. Mov Disord. 2015;30(4):443-445.
  18. van Wamelen D, Grigoriou S, Chaudhuri K, Odin P. Continuous Drug Delivery Aiming Continuous Dopaminergic Stimulation in Parkinson’s Disease. J Parkinsons Dis. 2018;8(s1):S65-S72.
  19. Martinez-Martin P, Reddy P, Katzenschlager R, et al. EuroInf: A Multicenter Comparative Observational Study of Apomorphine and Levodopa Infusion in Parkinson’s Disease. Mov Disord. 2015;30(4):510-516.
  20. De Fabregues O, Dot J, Abu-Suboh M, et al. Long-term safety and effectiveness of levodopa-carbidopa intestinal gel infusion. Brain Behav. 2017;7:e00758.
  21. ClinicalTrials.gov. Study Comparing Intravenous and Subcutaneous Infudopa With Intestinal Duodopa in Patients With Parkinson’s Disease (IPO-001). https://clinicaltrials.gov/ct2/show/NCT03419806. Published 2018. Accessed 15 January, 2020.
  22. ClinicalTrials.gov. A Study in Subjects With Parkinson’s Disease to Evaluate the Safety and Tolerability of Titration and Continuous Subcutaneous Infusion of ABBV-951 in an Outpatient Environment. https://clinicaltrials.gov/ct2/show/NCT03374917. Published 2017. Accessed 15 January, 2020.
  23. ClinicalTrials.gov. A Clinical Trial Investigating the Efficacy, Safety and Tolerability of Continuous Subcutaneous ND0612 Infusion in Comparison to Oral IR-LD/CD in Subjects With Parkinson’s Disease Experiencing Motor Fluctuations (BouNDless). https://clinicaltrials.gov/ct2/show/NCT04006210. Published 2019. Accessed 15 January, 2020.
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