Infusion therapy better than pills at reducing Parkinson’s symptoms

Parkinson’s disease affects more than 8.5 million people worldwide and its prevalence has doubled in the past 25 years. Parkinson’s symptoms such as tremors, slowness and stiffness are caused by low levels of dopamine in the body. Oral levodopa, the most effective drug used to treat these motor symptoms, is converted into dopamine in the brain. But over time, its benefits tend to last less than a few hours, necessitating increases in doses or its frequency.

An international, multisite phase 3 trial published in the Lancet Neurology has found that continuous, 24-hour levodopa delivery through a subcutaneous infusion pump is safe and effective at reducing symptoms for longer periods of time. For the trial, 381 patients with Parkinson’s disease in 16 countries were randomised to receive continuous subcutaneous infusion of levodopa, or oral levodopa.

Delivering levodopa through the infusion pump was safe and associated with almost two hours a day of additional “on” time when the medication is working and symptoms are controlled, compared with oral levodopa. The patients also performed better on four of nine other disease rating scales that looked at disability from Parkinson’s disease symptoms. The most common adverse events were reactions at the infusion site.

“Once approved, this will become an important treatment strategy to consider for patients with Parkinson’s disease experiencing motor fluctuations not adequately controlled with medication,” the study said.