Motor Efficacy of Subcutaneous DIZ102, Intravenous DIZ101 or Intestinal Levodopa/Carbidopa Infusion
Bergquist, Filip ; Ehrnebo, Mats ; Nyholm, Dag ; Johansson, Anders ; Lundin, Fredrik ; Odin, Per LU
; Svenningsson, Per
; Dizdar, Nil
and Eriksson, Elias
(2024)
In Movement Disorders Clinical Practice
- Abstract
Background: It has been suggested that carbidopa at high blood concentrations may counter the therapeutic effect of levodopa in Parkinson's disease by entering the brain and blocking central levodopa conversion to dopamine. We previously demonstrated equivalent plasma levodopa concentration in patients with Parkinson's disease during 16 h of (1) intravenous carbidopa/levodopa (DIZ101) infusion, (2) subcutaneous carbidopa/levodopa (DIZ102) infusion or (3) intestinal carbidopa/levodopa gel infusion. Plasma levels of carbidopa were however approximately four times higher with DIZ101 and DIZ102 than with LCIG, and higher than those usually observed with oral levodopa/carbidopa. Objectives: To investigate if high carbidopa blood... (More)
Background: It has been suggested that carbidopa at high blood concentrations may counter the therapeutic effect of levodopa in Parkinson's disease by entering the brain and blocking central levodopa conversion to dopamine. We previously demonstrated equivalent plasma levodopa concentration in patients with Parkinson's disease during 16 h of (1) intravenous carbidopa/levodopa (DIZ101) infusion, (2) subcutaneous carbidopa/levodopa (DIZ102) infusion or (3) intestinal carbidopa/levodopa gel infusion. Plasma levels of carbidopa were however approximately four times higher with DIZ101 and DIZ102 than with LCIG, and higher than those usually observed with oral levodopa/carbidopa. Objectives: To investigate if high carbidopa blood concentrations obtained with parenteral levodopa/carbidopa (ratio 8:1) counter the effect of levodopa on motor symptoms. Methods: Eighteen patients with advanced Parkinson's disease were administered DIZ101, DIZ102, and intestinal levodopa/carbidopa gel for 16 h on different days in randomized order. Video recordings of a subset of the motor examination in the Unified Parkinson's Disease Rating Scale (UPDRS) were evaluated by raters blinded for treatment and time. Motor function was also measured using a wrist-worn device monitoring bradykinesia, dyskinesia, and tremor (Parkinson KinetiGraph). Results: There was no tendency for poorer levodopa effect with DIZ101 or DIZ102 as compared to LCIG. Conclusion: Although DIZ101 or DIZ102 causes approximately four times higher plasma carbidopa levels than LCIG, patients responded equally well to all treatments. The results do not indicate that high plasma carbidopa levels hamper the motor efficacy of levodopa.
(Less)
- author
- Bergquist, Filip
; Ehrnebo, Mats
; Nyholm, Dag
; Johansson, Anders
; Lundin, Fredrik
; Odin, Per
LU
; Svenningsson, Per
; Dizdar, Nil
and Eriksson, Elias
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- in press
- subject
- keywords
- carbidopa, continuous subcutaneous infusion, levodopa, Parkinson's disease
- in
- Movement Disorders Clinical Practice
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:85196664421
- pmid:38924339
- ISSN
- 2330-1619
- DOI
- 10.1002/mdc3.14138
- language
- English
- LU publication?
- yes
- id
- 3aae14d0-5ce9-4881-bd63-f2ad07f13de5
- date added to LUP
- 2024-09-03 11:23:06
- date last changed
- 2024-09-04 03:00:26
@article{3aae14d0-5ce9-4881-bd63-f2ad07f13de5,
abstract = {{<p>Background: It has been suggested that carbidopa at high blood concentrations may counter the therapeutic effect of levodopa in Parkinson's disease by entering the brain and blocking central levodopa conversion to dopamine. We previously demonstrated equivalent plasma levodopa concentration in patients with Parkinson's disease during 16 h of (1) intravenous carbidopa/levodopa (DIZ101) infusion, (2) subcutaneous carbidopa/levodopa (DIZ102) infusion or (3) intestinal carbidopa/levodopa gel infusion. Plasma levels of carbidopa were however approximately four times higher with DIZ101 and DIZ102 than with LCIG, and higher than those usually observed with oral levodopa/carbidopa. Objectives: To investigate if high carbidopa blood concentrations obtained with parenteral levodopa/carbidopa (ratio 8:1) counter the effect of levodopa on motor symptoms. Methods: Eighteen patients with advanced Parkinson's disease were administered DIZ101, DIZ102, and intestinal levodopa/carbidopa gel for 16 h on different days in randomized order. Video recordings of a subset of the motor examination in the Unified Parkinson's Disease Rating Scale (UPDRS) were evaluated by raters blinded for treatment and time. Motor function was also measured using a wrist-worn device monitoring bradykinesia, dyskinesia, and tremor (Parkinson KinetiGraph). Results: There was no tendency for poorer levodopa effect with DIZ101 or DIZ102 as compared to LCIG. Conclusion: Although DIZ101 or DIZ102 causes approximately four times higher plasma carbidopa levels than LCIG, patients responded equally well to all treatments. The results do not indicate that high plasma carbidopa levels hamper the motor efficacy of levodopa.</p>}},
author = {{Bergquist, Filip and Ehrnebo, Mats and Nyholm, Dag and Johansson, Anders and Lundin, Fredrik and Odin, Per and Svenningsson, Per and Dizdar, Nil and Eriksson, Elias}},
issn = {{2330-1619}},
keywords = {{carbidopa; continuous subcutaneous infusion; levodopa; Parkinson's disease}},
language = {{eng}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Movement Disorders Clinical Practice}},
title = {{Motor Efficacy of Subcutaneous DIZ102, Intravenous DIZ101 or Intestinal Levodopa/Carbidopa Infusion}},
url = {{http://dx.doi.org/10.1002/mdc3.14138}},
doi = {{10.1002/mdc3.14138}},
year = {{2024}},
}