皮下注射左旋多巴复古分子的新引擎

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY

Neurology and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI:10.1007/s40120-024-00635-4

Karolina Poplawska-Domaszewicz, Lucia Batzu, Cristian Falup-Pecurariu, K Ray Chaudhuri

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引用次数: 0

摘要

帕金森病（Parkinson's disease，PD）的治疗方法不断发展，旨在提供持续给药（CDD）的非口服左旋多巴疗法也取得了进展。这些疗法解决了与口服左旋多巴相关的运动波动、运动障碍和非运动波动（NMF）的出现所带来的挑战，并有助于确定帕金森病的晚期阶段。本综述的重点放在皮下注射磷左多巴/磷卡比多巴（Foslevodopa/foscarbidopa）上，展示了其最近的临床应用及其在提供持续左旋多巴给药方面的疗效。在概述其他非口服左旋多巴类 CDD 系统（如空肠内左旋多巴-卡比多巴输注和左旋多巴-恩他卡朋-卡比多巴输注）的同时，我们强调了福斯莱福多巴/福斯卡比多巴目前有望改善晚期帕金森病患者 "准时 "用药、无运动障碍和减少 "停药 "时间的证据。此外，磷左多巴/磷卡比多巴在控制清晨停药期、睡眠质量以及其他运动和非运动症状方面也具有潜力。此外，还讨论了其他非口服 CDD 选择，如 ND0612 和 DIZ102/DIZ101，重点是它们的药代动力学/药效学、疗效和安全性。虽然这些进展提供了新的治疗途径，但仍需进行长期观察研究，以阐明它们对现有帕金森病疗法的影响。总之，本综述深入分析了非口服 CDD 疗法不断发展的现状，并为将这些疗法纳入临床实践提供了务实的方法。

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Subcutaneous Levodopa: A New Engine for the Vintage Molecule.

The management of Parkinson's disease (PD) continues to evolve with advancements in non-oral levodopa-based therapies aiming to provide continuous drug delivery (CDD). Such therapies address the challenges posed by the emergence of motor fluctuations, dyskinesias, and non-motor fluctuations (NMF) associated with oral levodopa administration and contributing to define the advanced stage of PD. The key focus of this review is placed on subcutaneous foslevodopa/foscarbidopa (Foslevodopa/foscarbidopa) infusion, showcasing its recent clinical availability and efficacy in providing continuous levodopa delivery. While providing an overview of the other non-oral levodopa-based CDD systems, such as intrajejunal levodopa-carbidopa infusion and levodopa-entacapone-carbidopa infusion, we highlight the current promising evidence for Foslevodopa/foscarbidopa to improve, for example, "on time" without troublesome dyskinesia and reducing "off time" in people with advanced PD. Additionally, Foslevodopa/foscarbidopa demonstrates potential in managing early morning off periods, sleep quality and other motor and non-motor symptoms. Moreover, other non-oral CDD options such as ND0612 and DIZ102/DIZ101 are discussed, with focus on their pharmacokinetics/pharmacodynamics, efficacy, and safety profiles. While these advancements present new therapeutic avenues, long-term observational studies are warranted to elucidate their impact on existing PD therapies. Overall, this review provides insights into the evolving landscape of non-oral CDD therapies and offers a pragmatic approach for their integration into clinical practice.

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来源期刊

Neurology and Therapy CLINICAL NEUROLOGY-

CiteScore

5.40

自引率

8.10%

发文量

103

审稿时长

6 weeks

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