Non-Oral Drug Delivery in Parkinson’s Disease: Current Applications and Future

Güneş, Meliha; Karavana, Sinem Yaprak

doi:10.4274/tjps.galenos.2021.95226

Cited by 7 publications

(2 citation statements)

References 76 publications

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“…In the later stages of PD, the short- and long-term responses to dopaminergic drugs are reduced, and the inability to store excess dopamine necessitates higher and more frequent doses of levodopa ( Rosqvist et al, 2018 ). Some studies suggested that improving constipation might help regulate the absorption of dopaminergic drugs in the intestine, thereby delaying this phenomenon ( Güneş and Karavana, 2022 ). A limitation of this study is that the study period was too short, and we were unable to observe the effect of acupuncture on levodopa dose by improving constipation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of acupuncture for the treatment of Parkinson’s disease-related constipation (PDC): A randomized controlled trial

Leong

Fan

et al. 2023

Front. Neurosci.

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ObjectiveTo evaluate the efficacy of acupuncture in treating Parkinson’s disease-related constipation (PDC).Materials and methodsThis was a randomized, controlled trial in which patients, outcome assessors, and statisticians were all blinded. Seventy-eight eligible patients were randomly assigned to either the manual acupuncture (MA) or sham acupuncture (SA) groups and received 12 sessions of treatment over a 4-week period. Following treatment, patients were monitored until the eighth week. The primary outcome was the change in weekly complete spontaneous bowel movements (CSBMs) from baseline after treatment and follow-up. The Constipation Symptom and Efficacy Assessment Scale (CSEAS), the Patient-Assessment of Constipation Quality of Life questionnaire (PAC-QOL), and the Unified Parkinson’s Disease Rating Scale (UPDRS) were used as secondary outcomes.ResultsIn the intention-to-treat analysis, 78 patients with PDC were included, with 71 completing the 4-week intervention and 4-week follow-up. When compared to the SA group, weekly CSBMs were significantly increased after treatment with the MA group (P < 0.001). Weekly CSBMs in the MA group were 3.36 [standard deviation (SD) 1.44] at baseline and increased to 4.62 (SD, 1.84) after treatment (week 4). The SA group’s weekly CSBMs were 3.10 (SD, 1.45) at baseline and 3.03 (SD, 1.25) after treatment, with no significant change from baseline. The effect on weekly CSBMs improvement in the MA group lasted through the follow-up period (P < 0.001).ConclusionAcupuncture was found to be effective and safe in treating PDC in this study, and the treatment effect lasted up to 4 weeks.Clinical trial registrationhttp://www.chictr.org.cn/index.aspx, identifier ChiCTR2200059979

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Section: Discussionmentioning

confidence: 99%

Efficacy of acupuncture for the treatment of Parkinson’s disease-related constipation (PDC): A randomized controlled trial

Leong

Fan

et al. 2023

Front. Neurosci.

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“…Rasagiline mesylate (RSM) is a second-generation monoamine oxidase inhibitor [ 7 , 8 ]. Unlike selegiline (the first monoamine oxidase inhibitor used for Parkinson’s disease treatment), RSM does not produce amphetamine-like metabolites and is not accompanied by the neurotoxic side effects caused by these metabolites [ 9 ]. However, RSM produces a neuroprotective metabolite called L-aminoindane, which in turn leads to a lower recommended therapeutic daily dose [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Investigating the Targeting Power to Brain Tissues of Intranasal Rasagiline Mesylate-Loaded Transferosomal In Situ Gel for Efficient Treatment of Parkinson’s Disease

et al. 2023

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Rasagiline mesylate (RSM) is a hydrophilic drug with poor oral bioavailability (36%) because of hepatic first-pass metabolism. The present study focuses on delivering RSM directly to the brain through its inclusion within transferosomal in situ gel administered through the intranasal (IN) route. Transferosomes were formed by the thin-film hydration method with the aid of Design-Expert® software by varying the edge activator (EA) type in the absence or presence of cholesterol. By desirability calculations, the optimum formulation was composed of phosphatidylcholine and sodium deoxycholate as an EA (5:1%w/w) with no cholesterol. The optimum formulation was 198.63 ± 34.98 nm in size and displayed an entrapment efficiency of 95.73 ± 0.09%. Transmission electron microscopy revealed discrete and spherical vesicles. Optimized transferosomes were further incorporated into an in situ gel composed of 0.5% pectin, 15% Pluronic® F-127, and 5% Pluronic® F-68 and tested for the in vivo performance. The systemic as well as brain kinetics were assessed in rats by comparing the IN-administered in situ gel to the IV aqueous solution. The optimum in situ gel showed safety and biocompatibility on rats’ nasal mucosa with enhanced brain bioavailability (131.17%). Drug targeting efficiency and direct transport percentage indices (304.53% and 67.16%, respectively) supported successful brain targeting offering direct nose-to-brain drug delivery.

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Non-oral continuous drug delivery based therapies and sleep dysfunction in Parkinson’s disease

et al. 2023

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Continuous drug delivery (CDD) has emerged as a feasible and pragmatic therapeutic option for dopamine replacement therapy in advanced Parkinson’s disease (PD). CDD aims to mimic the physiological tonic dopamine release from striatal dopaminergic neurons and thus reduces the severity and duration of motor and non-motor fluctuations partly related to pulsatile levodopa stimulation. Non-motor symptoms and fluctuations are ubiquitous in PD and include sleep dysfunction, a problem that occurs in over 90% of PD patients across all stages, from prodromal to palliative. In this review, we discuss the currently available and in development non-oral dopaminergic CDD strategies with a focus on their efficacy in the treatment of the burdensome sleep dysfunction in PD.

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Non-Oral Drug Delivery in Parkinson’s Disease: Current Applications and Future

Cited by 7 publications

References 76 publications

Efficacy of acupuncture for the treatment of Parkinson’s disease-related constipation (PDC): A randomized controlled trial

Efficacy of acupuncture for the treatment of Parkinson’s disease-related constipation (PDC): A randomized controlled trial

Investigating the Targeting Power to Brain Tissues of Intranasal Rasagiline Mesylate-Loaded Transferosomal In Situ Gel for Efficient Treatment of Parkinson’s Disease

Non-oral continuous drug delivery based therapies and sleep dysfunction in Parkinson’s disease

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