23rd January 2015 - New research

RELUCTANCE TO START PARKINSON'S DISEASE TREATMENT

The first study to assess the reluctance to start medication in Parkinson's Disease has found a reluctance to begin medication that is primarily due to a fear about side effects and a refusal to accept a diagnosis of Parkinson's Disease.

The most common reasons reported by patients for not starting Parkinson's Disease treatments were : the fear of side effects (55%), followed by the refusal to acceptance a diagnosis of Parkinson's Disease (36%). However, the main concern of physicians in starting Parkinson's Disease drugs was their temporary and limited benefits (34%). Patients were more than twice as reluctant to start dopamine agonists compared with starting L-Dopa. In contrast, physicians perceived starting L-dopa to be far more associated with greater reluctance.

People with Parkinson's Disease and physicians therefore clearly have a very different perspective on the issue of reluctance to start medication. The researchers suggest that there is a need to bring physicians and patients with Parkinson's Disease closer to a shared vision of the problem reluctance to start medication.

Reference : Parkinsonism Related Disorders [2014] 20 (6) : 608-612 (T.A.Mestre, T. Teodoro, W.Reginold, J.Graf, M.Kasten, J.Sale, M.Zurowski, J.Miyasaki, J.J.Ferreira, C. Marras)  Complete abstract  In order to refer to this article on its own click here

18th January 2015 - New research

HYDROCARBONS INCREASE THE RISK OF PARKINSON'S DISEASE

Exposure to hydrocarbons has been found to significantly increase the likelihood of developing Parkinson's Disease. This was based on by far the largest assessment of its kind. Prior to this study there had not been a consensus concerning hydrocarbons as a cause of Parkinson's Disease.

Hydrocarbon poisoning such as that of benzene and petroleum usually occurs accidentally by their inhalation or ingestion. Sources of hydrocarbons include : natural gas, cooking gas, petrol, gasoline. For more information go to : Hydrocarbon 

People with Parkinson's Disease were assessed according to several factors including their previous working exposure to hydrocarbons. Thirteen case controlled studies were made use of in assessing the likelihood of developing Parkinson's Disease. Hydrocarbon exposure increased the likelihood of Parkinson's Disease by 1.32 times normal. Occupational exposure of hydrocarbons increased the likelihood of developing Parkinson's Disease to 1.61 times normal. The biochemical cause of the association was not proposed.

This systematic review supports a positive association between hydrocarbon exposure and Parkinson's Disease. In some people the likelihood of devloping Parkinson's Disease was four times normal. A more emphatic relationship may have been obtained if the degree of exposure was also considered.

Reference : Parkinsonism Related Disorders [2014] Dec 26 [Epub ahead of print] (O.Palin, C.Herd, K.E.Morrison, A.C.Jagielski, K.Wheatley, G.N.Thomas, C.E.Clarke) Complete abstract  In order to refer to this article on its own click here

10th January 2015 - New research

DUAL RELEASE L-DOPA APPROVED FOR PARKINSON'S DISEASE

Rytary, which is produced by Impax, has been approved by the FDA (in the USA) for use in the treatment of Parkinson's Disease. Impax expects Rytary to be available for use in February 2015. Most forms of L-dopa are either immediate release, which can cause an excessive effect, or controlled release, which can be slow to start having effect. Rytary is advantageous due to including both immediate release and prolonged release L-dopa.

Rytary can also be used for post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication or manganese intoxication. Rytary is designed to address one of the most significant unmet needs for patients living with Parkinson's disease, which is to reduce the amount of time during the day when their symptoms are not adequately controlled.

Rytary is combined with carbidopa in a 4 : 1 ratio in order to maintain its effect. There are four strengths of Rytary (carbidopa/ levodopa) :, 23.75mg/95mg, 36.25mg/145mg, 48.75mg/195mg, and 61.25mg/ 245mg. Rytary may be swallowed whole or, for patients who have trouble swallowing, the capsule may be opened and the beads sprinkled on to food and consumed immediately.

In advanced Parkinson's Disease Rytary reduced the percentage of "off" time (by 37% to 23%) when compared to immediate-release carbidopa-levodopa. The most common adverse reactions with Rytary (in at least 5% of patients and more frequently than in placebo) were nausea, dizziness, headache, insomnia, abnormal dreams, dry mouth, dyskinesia, anxiety, constipation, vomiting, and orthostatic hypotension. The most common adverse reactions in advanced Parkinson's Disease were nausea and headache. For more information go to the News Release for 08 Jan 2015 News release   In order to refer to this article on its own click here

1st January 2015 - New research

CLINICAL TRIALS OF SUBCUTANEOUS L-DOPA

NeuroDerm has announced results of Phase IIa pharmacokinetic Study of ND0612H and ND0612L. They led to clinically-significant plasma levels of L-dopa. ND0612 is a combination of L-dopa and carbidopa in a liquid formula administered continuously sub-cutaneously through a patch pump. ND0612 is designed to provide steady L-dopa blood levels for the reduction of motor complications in Parkinson's Disease. There is a high dose form ND0612H. For more information go to ND0612H  There is a low dose form of ND0612 called ND0612L. For more information go to ND0612L

L-dopa plasma levels were found to be proportionate to the dose. ND0612H achieved maximum daytime concentrations of 1,333ng/ml and 1,436ng/ml. With oral entacapone the levels were even higher, at 1,807ng/ml. ND0612L achieved lower maximum daytime concentrations of 528ng/ml and 477ng/ml. With oral entacapone the L-dopa levels were slightly higher, at 596ng/ml. Fluctuations in L-dopa plasma levels were markedly reduced when compared with oral L-dopa. Treatment with ND0612L and ND0612H did not raise safety and tolerability concerns, causing only minimal and transient local reactions at the infusion site. Due to the short half-life of oral L-dopa, patients are required to take multiple L-dopa doses daily. This results in sharp fluctuations in L-dopa levels which are associated with erratic "off" and "on" periods experienced by many patients.

Continuous sub-cutaneous L-dopa administration using ND0612 can overcome this limitation without having to undergo invasive surgical procedure. For more information go to Neuroderm  In order to refer to this article on its own click here