How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Brinker, Dana; Smilowska, Katarzyna; Paschen, Steffen; Antonini, Angelo; Moro, Elena; Deuschl, Günther

doi:10.1002/mdc3.13962

Cited by 4 publications

(1 citation statement)

References 125 publications

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“…However, as the guideline by its nature was primarily based on high quality randomized controlled studies, the information of smaller studies and personal expertise are lacking. In a second publication, more specific recommendations for individual patient groups were derived based on this guideline; however, this work does not include LECIG and foslevodopa/foscarbidopa (Brinker et al 2023).…”

Section: Introductionmentioning

confidence: 99%

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Schröter,

Sajonz,

Jost

et al. 2024

J Neural Transm

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Device aided therapies (DAT) comprising the intrajejunal administration of levodopa/carbidopa intestinal gel (LCIG) and levodopa/carbidopa/entacapone intestinal gel (LECIG), the continuous subcutaneous application of foslevodopa/foscarbidopa or apomorphine infusion (CSAI) and deep brain stimulation (DBS) are used to treat Parkinson’s disease with insufficient symptom alleviation under intensified pharmacotherapy. These DAT significantly differ in their efficacy profiles, indication, invasiveness, contraindications, and potential side effects. Usually, the evaluation of all these procedures is conducted simultaneously at the same point in time. However, as disease progression and symptom burden is extremely heterogeneous, clinical experience shows that patients reach the individual milestones for a certain therapy at different points in their disease course. Therefore, advocating for an individualized therapy evaluation for each DAT, requiring an ongoing evaluation. This necessitates that, during each consultation, the current symptomatology should be analyzed, and the potential suitability for a DAT be assessed. This work represents a critical interdisciplinary appraisal of these therapies in terms of their individual profiles and compares these DAT regarding contraindications, periprocedural considerations as well as their efficacy regarding motor- and non-motor deficits, supporting a personalized approach.

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Section: Introductionmentioning

confidence: 99%

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Schröter,

Sajonz,

Jost

et al. 2024

J Neural Transm

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Subcutaneous Levodopa: A New Engine for the Vintage Molecule

Poplawska-Domaszewicz,

Batzu,

Falup-Pecurariu

et al. 2024

Neurol Ther

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The management of Parkinson’s disease (PD) continues to evolve with advancements in non-oral levodopa-based therapies aiming to provide continuous drug delivery (CDD). Such therapies address the challenges posed by the emergence of motor fluctuations, dyskinesias, and non-motor fluctuations (NMF) associated with oral levodopa administration and contributing to define the advanced stage of PD. The key focus of this review is placed on subcutaneous foslevodopa/foscarbidopa (Foslevodopa/foscarbidopa) infusion, showcasing its recent clinical availability and efficacy in providing continuous levodopa delivery. While providing an overview of the other non-oral levodopa-based CDD systems, such as intrajejunal levodopa–carbidopa infusion and levodopa–entacapone–carbidopa infusion, we highlight the current promising evidence for Foslevodopa/foscarbidopa to improve, for example, “on time” without troublesome dyskinesia and reducing “off time” in people with advanced PD. Additionally, Foslevodopa/foscarbidopa demonstrates potential in managing early morning off periods, sleep quality and other motor and non-motor symptoms. Moreover, other non-oral CDD options such as ND0612 and DIZ102/DIZ101 are discussed, with focus on their pharmacokinetics/pharmacodynamics, efficacy, and safety profiles. While these advancements present new therapeutic avenues, long-term observational studies are warranted to elucidate their impact on existing PD therapies. Overall, this review provides insights into the evolving landscape of non-oral CDD therapies and offers a pragmatic approach for their integration into clinical practice.

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Response to letter to the editor regarding “Does the 5-2-1 criteria identify patients with advanced Parkinson’s disease? Real-world screening accuracy and burden of 5-2-1-positive patients in 7 countries”

Antonini,

Chaudhuri,

Domingos

et al. 2024

BMC Neurol

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The 5-2-1 criteria was developed to facilitate the identification and referral of patients with Parkinson’s Disease (PD) inadequately controlled by oral medications. The criterion was not developed to screen patients with PD for device-aided therapy eligibility. The robust design and validation of the 5-2-1 criteria minimizes over or inappropriate referrals, and supports physicians in the timely identification of patients with PD who may warrant further evaluation for treatment optimization. This response letter clarifies concerns raised by Moes et al.

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How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Cited by 4 publications

References 125 publications

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Advanced therapies in Parkinson’s disease: an individualized approach to their indication

Subcutaneous Levodopa: A New Engine for the Vintage Molecule

Response to letter to the editor regarding “Does the 5-2-1 criteria identify patients with advanced Parkinson’s disease? Real-world screening accuracy and burden of 5-2-1-positive patients in 7 countries”

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