Parkinson’s disease is a neurological condition affecting over 8.5 million individuals worldwide and has doubled in prevalence over the last 25 years. It is characterized by the loss of dopaminergic cells in the brain, leading to symptoms such as motor control issues, shakes, rigidity, slow movement, balance problems, and sensory problems. Levodopa is the most effective drug for treating motor control symptoms, but its efficacy decreases over time as the disease progresses. While there is no cure for Parkinson’s disease, treatments such as medication, deep brain stimulation surgery, and therapy can help manage symptoms and improve quality of life.
Many medications used to treat Parkinson’s, including levodopa and dopamine agonists, can lose effectiveness over time, leading to motor fluctuations and dyskinesias. Deep brain stimulation surgery is effective for many patients but comes with risks such as infection, stroke, hemorrhage, and hardware complications. Other potential treatments include physical, occupational, and speech therapy tailored to individual needs. Previous studies have suggested that continuous infusion of levodopa could improve the drug’s efficacy in controlling movement problems. A Phase III trial compared the efficacy of oral levodopa to continuous subcutaneous infusion in 243 participants, finding that continuous infusion was associated with reduced dyskinesia and improved disability from Parkinson’s symptoms.
Researchers used a double-blind, “double dummy” design to prevent bias during the trial. Participants received either levodopa or a placebo via an infusion device, in addition to their regular oral medication. They then recorded the effects of the medication on their symptoms every 30 minutes in a home diary. Continuous infusion of levodopa resulted in a significant reduction in troublesome dyskinesia and improvement on disease rating scales compared to oral levodopa. Participants had the option to continue treatment with the subcutaneous infusion device in a further clinical trial. Side effects were mainly related to reactions at the device site, but the improvement in symptoms was attributed to achieving an optimal dosage of the drug without disrupting sleep.
The study authors suggest that continuous infusion of levodopa could be a beneficial intervention for those seeking to avoid surgery. The device offers a less invasive option for delivering the drug continuously compared to existing methods like a PEG-J infusion, which involves a tube in the stomach. Dr. Mary Feldman, a neurologist not involved in the research, explained that levodopa is absorbed subcutaneously, allowing patients to forget about taking pills and avoid the continuous cycle of taking medication and waiting for it to kick in. Continuous infusion of levodopa could provide patients with more freedom and improve their quality of life by eliminating the need to constantly monitor medication intake and timing. The device also offers a more appealing and less invasive alternative to existing methods of continuous levodopa delivery.
