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Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease

Patients with Parkinson’s disease often suffer from OFF symptoms disrupting their daily routines and adding to disabilities. Despite polypharmacy and adjustments to medication schedules, they often do not experience consistent relief from their motor symptoms. As the disease progresses, impaired gas...

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Detalles Bibliográficos
Autores principales: Martinez-Nunez, Alfonso E., LeWitt, Peter A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357202/
https://www.ncbi.nlm.nih.gov/pubmed/37182902
http://dx.doi.org/10.3233/JPD-230055
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author Martinez-Nunez, Alfonso E.
LeWitt, Peter A.
author_facet Martinez-Nunez, Alfonso E.
LeWitt, Peter A.
author_sort Martinez-Nunez, Alfonso E.
collection PubMed
description Patients with Parkinson’s disease often suffer from OFF symptoms disrupting their daily routines and adding to disabilities. Despite polypharmacy and adjustments to medication schedules, they often do not experience consistent relief from their motor symptoms. As the disease progresses, impaired gastric emptying may evolve, making it even more challenging for dopaminergic drugs to provide consistent results. This review focuses on a group of drugs that have the pharmacokinetic advantage of a much earlier onset of action by virtue of their non-oral routes of absorption. We compare the current marketed options: subcutaneous apomorphine, sublingual apomorphine, and inhaled levodopa. Subcutaneous apomorphine is the speediest to take effect, whereas sublingual apomorphine offers the longest clinical effect. Inhaled levodopa has the most favorable side effect profile among the three options. An inhaled form of apomorphine is currently under development, having passed safety and efficacy studies. Each of these drugs has unique characteristics for the user, including different side effect profiles and onset of action. The best choice for a patient will depend on individual needs and circumstances. In this review, we explore those nuances to allow clinicians to select the best option for their patients.
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spelling pubmed-103572022023-07-21 Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease Martinez-Nunez, Alfonso E. LeWitt, Peter A. J Parkinsons Dis Review Patients with Parkinson’s disease often suffer from OFF symptoms disrupting their daily routines and adding to disabilities. Despite polypharmacy and adjustments to medication schedules, they often do not experience consistent relief from their motor symptoms. As the disease progresses, impaired gastric emptying may evolve, making it even more challenging for dopaminergic drugs to provide consistent results. This review focuses on a group of drugs that have the pharmacokinetic advantage of a much earlier onset of action by virtue of their non-oral routes of absorption. We compare the current marketed options: subcutaneous apomorphine, sublingual apomorphine, and inhaled levodopa. Subcutaneous apomorphine is the speediest to take effect, whereas sublingual apomorphine offers the longest clinical effect. Inhaled levodopa has the most favorable side effect profile among the three options. An inhaled form of apomorphine is currently under development, having passed safety and efficacy studies. Each of these drugs has unique characteristics for the user, including different side effect profiles and onset of action. The best choice for a patient will depend on individual needs and circumstances. In this review, we explore those nuances to allow clinicians to select the best option for their patients. IOS Press 2023-06-13 /pmc/articles/PMC10357202/ /pubmed/37182902 http://dx.doi.org/10.3233/JPD-230055 Text en © 2023 – The authors. Published by IOS Press https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Martinez-Nunez, Alfonso E.
LeWitt, Peter A.
Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease
title Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease
title_full Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease
title_fullStr Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease
title_full_unstemmed Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease
title_short Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson’s Disease
title_sort drugs to the rescue: comparison of on-demand therapies for off symptoms in parkinson’s disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357202/
https://www.ncbi.nlm.nih.gov/pubmed/37182902
http://dx.doi.org/10.3233/JPD-230055
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