Friday, December 6, 2013

'Better' Levodopa Would 'Mean Everything to Me'

Here is something that came across my desk from the Michael J Fox foundation this morning. This is pretty exciting to me, considering that I have several up-and-down periods during the day when I am revisited by tremors, and then have to wait an hour after I take the next dose of medication before I get symptom relief.


Posted by  Nate Herpich, November 21, 2013

'Better' Levodopa Would 'Mean Everything to Me'

The days vary greatly for Ellen Maguire, 54, an artist living with Parkinson's disease. Often, she spends hours working in her studio to create stained glass mosaics. But on other days, she feels like she's unable to get much done, stuck in a state of feeling like she's "moving through pudding."

Maguire experiences the roller coaster of "on/off periods" common to many people taking Parkinson's medication. Every three hours or so, she takes levodopa/carbidopa. On the good days, she can feel the medicine kick in quickly like magic; on the bad days, she feels little therapeutic effect.

"The off periods remind me almost every day that I have this disease," she says. "So I focus on the day I'm in because I never know what tomorrow will bring."

Improving an imperfect gold standard

It's a common refrain for many Parkinson's patients: What will tomorrow bring? Unpredictable on/off periods can greatly interfere with daily life, and are perhaps the major concern for people living with PD today. For this reason, in addition to looking for new drugs, The Michael J. Fox Foundation and the Parkinson's field at large are hard at work to improve existing treatments so that they more consistently deliver therapeutic benefits.

The key to success: finding better ways to deliver, and then maintain, therapeutic levels of levodopa in the bloodstream. "An improved delivery method is what I've always hoped for," says Maguire. "Something that would even out my days would mean everything to me."

Since it was first prescribed for Parkinson's in the late 1960s, levodopa has been the so-called gold standard therapy for PD. Today, people with Parkinson's take the drug in conjunction with carbidopa, a therapy meant to prolong the life of levodopa in the bloodstream, and, in turn, its therapeutic effect. But this combination, as Maguire can attest, is still largely imperfect.

Inhaled relief from on/off periods

The good news is, the past few years in PD research have returned significant and positive clinical study results for new therapies that have been shown to lessen on/off periods in people with PD.

This spring biotech Civitas Therapeutics announced positive clinical trial results for their inhaled formulation of levodopa, called CVT-301. The Phase 2a study, funded in part by MJFF, showed that, when administered to patients in an off state, CVT-301 provided a rapid improvement in motor function.

CVT-301 is designed to work as a sort of "rescue drug" to be taken in conjunction with the traditional pill form of levodopa/ carbidopa. The idea is that patients would be able to self-medicate by taking a puff from an inhaler when they feel an off period coming on. This puff would bring the amount of levodopa in the bloodstream back to a level that provides a therapeutic effect.

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