New trends in advanced parkinson disease stage therapy

Česká verze

Authors: Mária Kolesárová; Ondrej Franko; Dalibor Kolesár; Andrea Gažová; Ján Kyselovič
Published in the journal: Čes. slov. Farm., 2023; 72, 37-44
Category: Původní práce
doi: https://doi.org/https://doi.org/10.5817/CSF2023-1-37

Summary

The aim of the study was to point out the contribution of new invasive therapeutic procedures in the treatment of advanced stages of Parkinson’s disease (PD) in comparison with classical oral pharmacotherapy. Data originated from a group of 43 patients with PD, 39% (17) with classic treatment, 23% (10) with intestinal gel of methyl ester levodopa (Duodopa), 19% (8) of patients were using subcutaneous delivery of apomorphine (APO) and the same quantity of patients had undergone deep brain stimulation (DBS). Majority of patients had advanced stages of PD, stage 4, by standards of Hoehn and Yahr scale (Hoehn and Yahr, 1967). Research observed improvement in majority of patients with novel treatments. A positive effect was also noted in the reduced need for oral therapy, where there was a significant decrease in all new therapies. Benefits were observed in the amount of antiparkinsonic drugs taken per os, where we observed reduction in all new therapies. A positive effect of the new therapeutic approaches in reducing “off” periods in patients has also been noted. In the case of Duodopa and DBS, the ”off” period was shortened up to 50% and in the apomorphine pump up to 40%. Patients also reported reduction of some symptoms like rigidity, tremor and bradykinesis while dyskinesis still remains suba challenge. On the basis of the obtained results, it can be concluded that new therapeutic procedures for PCh will make it possible to manage symptoms typical of advanced stages of the disease, which without these procedures would lead to disability, which is the main reason for their indication. However, in early stages, well responding patients or in slow progressing disease oral antiparkinsonics are remaining as golden standard of treatment. This is not just due to good response but also because these classic drug formulations are significantly less expensive. In Slovakia, novel treatments are accessible through healthcare insurance only after secondary revision by insurance company doctors.

Keywords:

Parkinson’s disease – deep brain stimulation – pharmacotherapy – Duodopa – apomorphine pump

Zdroje

1. Gmitterová K., Minár M., Košutzká Z., Valkovič P. Terapia pokročilých štádií Parkinsonovej choroby invazívnymi postupmi. Cesk. Slov. Neuro. N. 2017; 80/113(5), 503–516.

2. Levy R., Hzrati L. N., Herreto M. T. Vila M., Hassani O. K., Mouroux M., Ruberg M., Asensi H., Agid Y., Féger J., Obeso J. A., Parent A., Hirsch E. C. Re-evaluation oft he functional anatomy of the basal ganglia in normal and Parkinsonian states. Neuroscience 1997; 76(2), 335–343.

3. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J. Neurol. Neurosurg. Psychiatry 2008; 79(4): 368–376.

4. Chaudhuri K. R., Healy D. K., Schapira A. H. Non-motor symptoms of Parkinson’s disease: Diagnosis and management. Lancet Neurol. 2006; 5, 235–245.

5. Fahn S., Jankovic J. Principles and practice of movement disorders. Philadelphia: Churchill Livingstone Elsevier 2007.

6. Hoehn M. M., Yahr M. D. Parkinsonism: onset, progression and mortality. Neurology 1967; 17(5), 427–442.

7. Cotzias G. C., van Woert M. H., Schiffer L. M. Aromatic amino acids and modification of parkinsonism. N. Engl. J. Med. 1967; 276(7), 374–379.

8. Švihovec J., a kol. Farmakologie. Praha: Grada Publishing 2018.

9. LeWitt P. A. Levodopa therapy for Parkinson’s disease: Pharmacokinetics and pharmacodynamics. Mov. Disord. 2015; 30(1), 64–72.

10. Kaňovský P., Farníková K. Farmakoterapie pokročilé Parkinsonovy nemoci ve světle doporučených postupů. Neurol. Prax 2010; 11(4), 241–245.

11. Růzicka E., Streitová H., Jech R., Kanovský P., Roth J., Rektorová I., Mecír P., Hortová H., Bares M., Hejduková B., Rektor I. Amantadine infusion in treatment of motor fluctuations and dyskinesias in Parkinson’s disease. J. Neural. Transm. (Vienna) 2000; 7(11), 1297–1306.

12. Storch A., Schneider C. B., Wolz M., Stürwald Y., Nebe A., Odin P., Mahler A., Fuchs G., Jost W. H., Chaudhuri K. R., Koch R., Reichmann H., Ebersbach G. Nonmotor fluctuations in Parkinson disease: severity and correlation with motor complications. Neurology 2013; 80(9), 800–809.

13. Ahlskog J. E., Muenter M. D. Frequency of levodopa-related dyskinesias and motor fluctuations as estimated from the culumative literature. Mov Disord. 2001; 16(3), 448–458.

14. Klempíř J., Havránková P., Jech R. Terapie Parkinsonovy nemoci levodopou v kontinuální enterální infuzi. Neurológia pre prax 2015; 16(2), 84–87.

15. Růžička E., Urgošík D., Jech R., Serranová T., Volfová M., Roth J., Vymazal J., Mečíř P., Nováková L., Nováková O., Ulmanová O., Brožová H., Dušek P., Špačková N., Liščák R., Vladyka V. Hluboká mozková stimulace v léčbě Parkinsonovy nemoci a třesu: Pražská zkušenost 1998–2003. Čes. Slov. Neurol. N. 2004; 67, 423–436.

16. Baláž M. Hluboká mozková stimulace u Parkinsonovy nemoci. Neurol. Praxi 2013; 14, 229–231.

17. Valkovič P. Súčasný pohľad na Parkinsonovu chorobu. Via pract. 2006; 3(5), 256–261.

18. Combs H. L., Folley B. S., Berry D. T., Segerstrom S. C., Han D. Y., Anderson-Mooney A. J., Walls B. D., van Horne C. Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson’s Disease: A Meta-Analysis. Neuropsychol. Rev. 2015; 25(4), 439–454.

19. Kaňovský P., Kubova D., Bares M., Hortova H., Streitova H., Rektor I., Znojil V. Levodopa-induced dyskinesias and continuous subcutaneous infusions of apomorphine: results of two-year, prospective follow-up. Mov. Disord. 2002; 17, 188–191.

20. Baláž M., Kianička B., Bareš M. Dlouhodobá terapie intraduodenální levodopou – kazuistiky tří pacientů. Neurol. Praxi 2014; 15 (3), 155–157.

21. Lee P. C., Lie L. L., Sun Y., Chen Y.-A., Liu C.-C., Li C.-Y., Yu H.-L., Ritz B. Traffic-related air pollution increase the risk of Parkinson’s disease in Taiwan: a nationwide study. Environ. Int. 2016; 96, 75–81.

22. Richter D. Súčasný pohľad na liečbu Parkinsonovej choroby. Edukafarm MediNews 2011; 1, 37–38.

23. Karadağ Y. S., Saltoğlu T., Küçükdağli F. E., Öztürk Ö., Köseoğlu H. T., Altiparmak E. Comprehensive assessment od levodopa-carbidopa intestinal gef for Turkish advanced Parkinson’s disease patients. Turkish Journal of Medical Sciences 2020; 51(1), 84–89.

24. Bohušová V., Necpál J. Analýza vplyvu antiparkinsoník na poruchy kontroly impulzov zisťovaných pomocou metódy samohodnotenia pacientmi. Folia Pharmaceutica cassoviensia 2020; II (2), 7–17.

25. Fox H. C., Katzenschlager R., Lim S. Y., Ravina B., Seppi K., Coelho M., Poewe W., Rascol O., Goetz CH. G., Sampaio C. The movement disorder society evidence-based medicine review update: treatments for the motor symptoms of Parkinson’s disease. Mov. Disord. 2011; Suppl 3, S2–41.

26. Thevathasan W., Debu B., Aziz T., Bloem B. R., Blahak Ch., Butson Ch., Czernecki V., Foltynie T., Fraix V., Grabli D., Joint C., Lozano A. M., Okun M. S., Ostrem J., Pavese N., Schrader Ch., Tai Ch-H, Krauss J. K., Moro E. Pedunculo-pontine nucleus deep brain stimulation in Parkinson‘s disease: A clinical review. Movement Disorders 2018; 33, 10–20.

27. Pessoa R. R., Moro A., Munhoz R. P., Teive H. A. G., Lees A. J. Apomorphine in the treatment of Parkinson’s disease: a review. Arquivod de Neuro-Psiquiatria 2018; 76(12), 840–848.

28. Wirdefeldt K. Odin P., Nyholm D. Levodopa-Carbidopa Intestinal Gel in Patients with Parkinson’s Disease: A Systematic Rewiev. CNS Drugs 2016; (5), 381–404.

29. Hoy, S. M. Levodopa/Carbidopa Enteral Suspension/ A Review in Advanced Parkinson’s Disease. Drugs 2019; 79(15), 1709–17171.

30. Katzenschlager R., Poewe W., Rascol O., Trenkwalder C., Deuschl G., Chaudhuri K. R., Henriksen T., van Laar T., Lockhart D., Staines H., Lees A. Long-term safety and efficacy of apomorphine infusion in Parkinson’s disease patients with persistent motor fluctuations: Results of the open-label phase of the TOLEDO study. Parkinsonism and Related Disorders 2021; 83, 79–85.

31. Loher T. J., Burgunder J.-M., Weber S., Sommerhalder R., Krauss J. K. Effect of chronic pallidal deep brain stimulation on off period dystonia and sensory symptoms in advanced Parkinson’s disease. Journal of Neurology Neurosurgery & Psychiatry 2002; 73(4), 395–399.