Although levodopa remains the "gold standard" to control motor deficits in the treatment of early stage PD, after four to six years of treatment with oral medications for Parkinson's disease, about 40% of patients find those medications less effective overall, inconsistent in controlling muscle function, and accompanied by a bothersome side-effect called dyskinesia, or involuntary muscle movement. By nine years of treatment, about 90% will suffer these effects.
April 23, 2015
Levodopa Gel Pump Relieves Symptoms for Parkinson's Patients
A headline I saw this morning on “Eureka Alert” -- one of many sites that pick up and share the latest stories -- got my attention: “Parkinson's patient experiences symptom relief with new medication.” The report appeared in the current issue of the Journal of Parkinson's Disease.
Among other things, the story describes one person’s remarkable success using CLES (Duopa®), a gel delivered directly into the small intestine by a portable infusion pump, providing continuous levodopa dosing.
The FDA approved the CLES gel in January, 2015. Its boosters believe this direct delivery system will be in much wider use later this year, particularly because the safety and efficacy of levodopa have already been clearly established.
Working with a team of international investigators, John Slevin -- MD and Professor of Neurology and Vice Chair of Research at University of Kentucky's Neuroscience Institute – tested the effectiveness of the new levodopa gel on patients with advanced symptoms of Parkinson’s disease (PD).
Dr. Slevin characterized his group’s findings: “We were extremely pleased with the results. Patients with advanced Parkinson Disease treated via this new method demonstrated marked improvement in symptom fluctuations with reduced dyskinesia.”
Pump or Pill
Why did the levodopa gel pumped directly into patients’ small intestines bring greater relief from PD symptoms than pills they’ve taken by mouth?
Slevin explained that the CLES gel pump creates more stable plasma concentrations of levodopa, in part because it avoids the patients’ erratic gastric activity. Especially for people with advanced PD, the muscles that control digestion are compromised like all the body’s muscles. That deterioration makes the levodopa dosing – both the amount and the timing – challenging.
No question: levodopa remains the “gold standard” med for treating the motor symptoms of PD, particularly in the disease’s earlier phases. But in time, its efficacy may dwindle.
According to the press release issued earlier this week by the University of Kentucky College of Medicine:
Enter Farmer Marion Fox
At the recent press conference (video below) announcing the results of the CLES gel’s trial, Slevin and his team introduced Marion Fox, a farmer and real estate developer from Georgetown, KY, who’d suffered from PD for 16 years.
When he learned about the three-year clinical trial for the CLES gel pump, Fox quickly signed up.
Before the new treatment -- even with regular medication adjustments – he’d begun to stagger around, and he struggled to speak and swallow. The progression of the disease was compromising the quality of his life and his time with family. He was ready to try a new therapeutic approach.
Mr Fox said he’s now feeling and moving around much better, dressing more easily, and spending all day farming his 800 acres: “I felt different right away. I'm getting more done. I'm not as good as I once was [before I had Parkinson's] but I'm pretty darn well off.”
Of course, this is just one man’s story. Nonetheless, Slevin and his team think there’ll be many similar successes for the CLES gel pump as it becomes a more standard treatment for people with advanced PD.
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Study results were published in the current issue of the Journal of Parkinson’s Disease.
Here’s the press conference at which Dr. Slevin’s group discusses the CLES levodopa gel pump, and farmer Cox tells his story.