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Continuous dopaminergic stimulation therapy for Parkinson's disease - Recent advances

Timpka, Jonathan LU ; Mundt-Petersen, Ulrika LU and Odin, Per LU orcid (2016) In Current Opinion in Neurology 29(4). p.474-479
Abstract

Purpose of review We aim to review the most interesting recent advances on the clinical aspects of continuous dopaminergic stimulation in Parkinson's disease. Recent findings Several large, open-label studies have presented data that are in line with the randomized controlled trial on L-dopa-carbidopa intestinal gel infusion, which shows that a continuous drug delivery can improve motor fluctuations and dyskinesia in patients with advanced Parkinson's disease. Furthermore, new extended-release formulations of L-dopa aim to stabilize plasma concentrations and thus reduce the degree of motor complications - despite a reduced number of daily doses. Transdermal rotigotine has been shown to be effective for specific subgroups of patients,... (More)

Purpose of review We aim to review the most interesting recent advances on the clinical aspects of continuous dopaminergic stimulation in Parkinson's disease. Recent findings Several large, open-label studies have presented data that are in line with the randomized controlled trial on L-dopa-carbidopa intestinal gel infusion, which shows that a continuous drug delivery can improve motor fluctuations and dyskinesia in patients with advanced Parkinson's disease. Furthermore, new extended-release formulations of L-dopa aim to stabilize plasma concentrations and thus reduce the degree of motor complications - despite a reduced number of daily doses. Transdermal rotigotine has been shown to be effective for specific subgroups of patients, although the general effect on nonmotor symptoms is still unclear. New products for L-dopa infusion are also at different stages of development, but the routes of administration are widely different: intrajejunal, subcutaneous, and oral. Summary The understanding of the mechanisms behind the complications of long-term L-dopa treatment is still not complete, but therapies aiming for continuous dopaminergic stimulation are already widely used in clinical practice and the evidence strength is improving. However, there is still an urgent need for both less invasive and less costly options in order to increase access to these therapies.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antiparkinson agents, continuous dopaminergic stimulation, continuous drug delivery, drugs, investigational, Parkinson's disease
in
Current Opinion in Neurology
volume
29
issue
4
pages
6 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:27272976
  • wos:000379207400011
  • scopus:84973299611
ISSN
1350-7540
DOI
10.1097/WCO.0000000000000354
language
English
LU publication?
yes
id
7fe67912-25a9-41b6-a2e2-efc5504881bb
date added to LUP
2016-07-19 07:34:38
date last changed
2024-01-04 10:08:17
@article{7fe67912-25a9-41b6-a2e2-efc5504881bb,
  abstract     = {{<p>Purpose of review We aim to review the most interesting recent advances on the clinical aspects of continuous dopaminergic stimulation in Parkinson's disease. Recent findings Several large, open-label studies have presented data that are in line with the randomized controlled trial on L-dopa-carbidopa intestinal gel infusion, which shows that a continuous drug delivery can improve motor fluctuations and dyskinesia in patients with advanced Parkinson's disease. Furthermore, new extended-release formulations of L-dopa aim to stabilize plasma concentrations and thus reduce the degree of motor complications - despite a reduced number of daily doses. Transdermal rotigotine has been shown to be effective for specific subgroups of patients, although the general effect on nonmotor symptoms is still unclear. New products for L-dopa infusion are also at different stages of development, but the routes of administration are widely different: intrajejunal, subcutaneous, and oral. Summary The understanding of the mechanisms behind the complications of long-term L-dopa treatment is still not complete, but therapies aiming for continuous dopaminergic stimulation are already widely used in clinical practice and the evidence strength is improving. However, there is still an urgent need for both less invasive and less costly options in order to increase access to these therapies.</p>}},
  author       = {{Timpka, Jonathan and Mundt-Petersen, Ulrika and Odin, Per}},
  issn         = {{1350-7540}},
  keywords     = {{antiparkinson agents; continuous dopaminergic stimulation; continuous drug delivery; drugs; investigational; Parkinson's disease}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{4}},
  pages        = {{474--479}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Current Opinion in Neurology}},
  title        = {{Continuous dopaminergic stimulation therapy for Parkinson's disease - Recent advances}},
  url          = {{http://dx.doi.org/10.1097/WCO.0000000000000354}},
  doi          = {{10.1097/WCO.0000000000000354}},
  volume       = {{29}},
  year         = {{2016}},
}