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Continuous Drug Delivery with Levodopa/Carbidopa Infusion: Review and First Data of a Dutch Cohort

Published online by Cambridge University Press:  07 November 2014

Extract

A duodenal levodopa (L-dopa) and carbidopa infusion has been developed to stabilize plasma levels of L-dopa, in order to reduce existing motor response fluctuations. Stable plasma levels have been shown to reduce these fluctuations significantly. A constant duodenal infusion with an L-dopa solution can improve response fluctuations, however L-dopa has very poor solubility. Only in an acidic environment can L-dopa be dissolved in large volumes. To supply 1 day of infusion with the conventional L-dopa solution, ∼4–5 liters are necessary, an inconvenience to most patients. With L-dopa/carbidopa infusion, L-dopa and carbidopa are concentrated in a water-based gel-like suspension to 20 mg/mL, which has reduced the infusion volumes to <100 mL/day.

Type
Expert Roundtable Supplement
Copyright
Copyright © Cambridge University Press 2008

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References

1.Nyholm, D. The rationale for continuous dopaminergic stimulation in advanced Parkinson's disease. Parkinsonism Rel Disord. 2007;13:1317.CrossRefGoogle ScholarPubMed
2.Nutt, JG. Continuous dopaminergic stimulation: is it the answer to the motor complications of levodopa? Mov Disord. 2007;22:19.CrossRefGoogle Scholar
3.Nilsson, D, Nyholm, D, Aquilonius, SM. Duodenal levodopa infusion in Parkinson's disease – long-term experience. Acta Neurol Scand. 2001;104:343348.CrossRefGoogle ScholarPubMed
4.Nilsson, D, Hansson, LE, Johansson, K, et al.Long-term intraduodenal infusion of a water based levodopa-carbidopa dispersion in very advanced Parkinson's disease. Acta Neurol Scand. 1998;97:175–83.CrossRefGoogle ScholarPubMed
5.Antonini, A, Isaias, IU, Canesi, Met al.Duodenal levodopa infusion for advanced Parkinson's disease: 12-month treatment outcome. Mov Disord. 2007;22:11451149.CrossRefGoogle ScholarPubMed
6.Nyholm, D, Nilsson Remahl, AIM, Dizdar, N, et al.Duodenal levodopa infusionmonotherapy vs oral polypharmacy in advanced Parkinson disease. Neurology. 2005;64:216223.CrossRefGoogle ScholarPubMed
7.Schrag, A, Selai, C, Jahanshahi, M, Quinn, NP. The EQ-5D--a generic quality of life measure-is a useful instrument to measure quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 2000;69:6773.CrossRefGoogle ScholarPubMed
8.Gancher, ST, Woodward, WR, Nutt, JG. Apomorphine tolerance in Parkinson's disease: lack of a dose effect. Clin Neuropharmacol. 1996;19:5964.CrossRefGoogle ScholarPubMed