Application of the concept of continuous dopaminergic stimulation for the management of Parkinson's disease

Intrathecal and intracerebroventricular dopamine for Parkinson's disease

While CDD directly to the CSF can provide a constant delivery of the dopaminergic drug resulting in a more stable treatment effect without the limitations of traditional oral therapy without peripheral effects, it is still young and longitudinal data is lacking. These experimental therapies show promise and further investigation into their efficacy and safety could extend the frontiers for management of PD.

Levodopa-carbidopa intestinal gel in a subgroup of patients with dyskinesia at baseline from the GLORIA Registry

Aim:

To evaluate long-term effects of levodopa–carbidopa intestinal gel on dyskinesia burden.

Patients & methods:

Posthoc analysis of the GLORIA registry assessed subgroups of advanced Parkinson's disease patients with <4 and ≥4 h/day of levodopa-induced dyskinesia at baseline.

Results & conclusions:

Mean dyskinesia duration significantly (p < 0.0001) decreased by 3.5 h in patients with ≥4 h baseline dyskinesia; conversely, dyskinesia duration increased by 1.6 h in patients with <4 h baseline dyskinesia. Quality of life improved in both subgroups. Adverse drug reactions occurred at similar rates in both subgroups. Despite increases in levodopa dose, levodopa–carbidopa intestinal gel treatment led to significant and sustained reductions in dyskinesia time, severity and associated pain in advanced Parkinson's disease patients with high baseline dyskinesia burden.