Continuous subcutaneous foslevodopa/foscarbidopa infusion for the treatment of motor fluctuations in Parkinson's disease: Considerations for initiation and maintenance

被引：15

作者：

Fung, Victor S. C. ^{[1
,2
]}

Aldred, Jason ^{[3
,4
]}

Arroyo, Martha P. ^{[5
]}

Bergquist, Filip ^{[6
,7
]}

Boon, Agnita J. W. ^{[8
]}

Bouchard, Manon ^{[9
,10
]}

Bray, Sarah ^{[1
]}

Dhanani, Sara ^{[11
]}

Facheris, Maurizio F. ^{[12
]}

Fisseha, Nahome ^{[13
]}

Freire-Alvarez, Eric ^{[14
]}

Hauser, Robert A. ^{[15
]}

Jeong, Anna ^{[12
]}

Jia, Jia ^{[12
]}

Kukreja, Pavnit ^{[12
]}

Soileau, Michael J. ^{[16
]}

Spiegel, Amy M. ^{[12
]}

Talapala, Saritha ^{[12
]}

Tarakad, Arjun ^{[17
]}

Urrea-Mendoza, Enrique ^{[18
,19
]}

Zamudio, Jorge ^{[12
]}

Pahwa, Rajesh ^{[20
]}

机构：

[1] Westmead Hosp, Movement Disorders Unit, Westmead, NSW, Australia

[2] Univ Sydney, Sydney Med Sch, Sydney, NSW, Australia

[3] Inland Northwest Res, Spokane, WA USA

[4] Selkirk Neurol, Spokane, WA USA

[5] Lakeside Dermatol, Libertyville, IL USA

[6] Univ Gothenburg, Dept Pharmacol, Gothenburg, Sweden

[7] Sahlgrens Univ Hosp, Dept Neurol, Gothenburg, Sweden

[8] Erasmus MC Univ Med Ctr, Dept Neurol, Rotterdam, Netherlands

[9] Univ Laval, Clin Neuro Levis, Levis, PQ, Canada

[10] Ctr Rech St Louis, Levis, PQ, Canada

[11] Banner Sun Hlth Res Inst, Sun City, AZ USA

[12] AbbVie Inc, N Chicago, IL USA

[13] AbbVie GK, Tokyo, Japan

[14] Gen Univ Hosp Elche, Neurol Dept, Elche, Spain

[15] Univ S Florida, Parkinsons Dis & Movement Disorders Ctr, Tampa, FL USA

[16] Texas Movement Disorder Specialists, Georgetown, TX USA

[17] Baylor Coll Med, Parkinsons Dis Ctr & Movement Disorders Clin, Houston, TX USA

[18] Prisma Hlth Neurol, Greenville, SC USA

[19] Univ South Carolina, Sch Med, Greenville, SC USA

[20] Univ Kansas, Parkinsons Dis & Movement Disorder Ctr, Med Ctr, Kansas City, KS USA

来源：

CLINICAL PARKINSONISM & RELATED DISORDERS | 2024年 / 10卷

关键词：

Levodopa; Carbidopa; Parkinson 's disease; Motor fluctuations; Subcutaneous infusion; Foslevodopa; Foscarbidopa; Treatment initiation; Treatment maintenance; POST HOC ANALYSIS; LEVODOPA; SAFETY; PHASE-3; TOLERABILITY; OPTIMIZATION; EXPERIENCE; ARM;

D O I：

10.1016/j.prdoa.2024.100239

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: As Parkinson's disease (PD) advances, management is challenged by an increasingly variable and inconsistent response to oral dopaminergic therapy, requiring special considerations by the provider. Continuous 24 h/day subcutaneous infusion of foslevodopa/foscarbidopa (LDp/CDp) provides steady dopaminergic stimulation that can reduce symptom fluctuation. Objective: Our aim is to review the initiation, optimization, and maintenance of LDp/CDp therapy, identify possible challenges, and share potential mitigations. Methods: Review available LDp/CDp clinical trial data for practical considerations regarding the management of patients during LDp/CDp therapy initiation, optimization, and maintenance based on investigator clinical trial experience. Results: LDp/CDp initiation, optimization, and maintenance can be done without hospitalization in the clinic setting. Continuous 24 h/day LDp/CDp infusion can offer more precise symptom control than oral medications, showing improvements in motor fluctuations during both daytime and nighttime hours. Challenges include infusion -site adverse events for which early detection and prompt management may be required, as well as systemic adverse events (eg, hallucinations) that may require adjustment of the infusion rate or other interventions. A learning curve should be anticipated with initiation of therapy, and expectation setting with patients and care partners is key to successful initiation and maintenance of therapy. Conclusion: Continuous subcutaneous infusion of LDp/CDp represents a promising therapeutic option for individuals with PD. Individualized dose optimization during both daytime and nighttime hours, coupled with patient education, and early recognition of certain adverse events (plus their appropriate management) are required for the success of this minimally invasive and highly efficacious therapy.

引用

页数：10

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