From the Guidelines
Recent developments in Parkinson's disease research have focused on improving motor function and reducing morbidity, with a emphasis on non-invasive treatments and personalized medicine, as seen in the 2022 study by Rodriguez-Porcel et al. 1.
Overview of Recent Developments
The study by Rodriguez-Porcel et al. 1 highlights the importance of motor function assessment in Parkinson's disease, and the need for more accurate and reliable measures of motor symptoms.
- The use of validated scales such as the UPDRS and MDS-UPDRS is recommended to measure parkinsonism and incorporate a survey for falls.
- The study also suggests that wearable sensors and kinematic analysis tools may be useful in capturing changes in motor function, especially in unsupervised conditions.
Nutrition and Swallowing Interventions
In addition to motor function assessment, research has also focused on nutrition and swallowing interventions in Parkinson's disease patients.
- A 2018 study by the ESPEN guideline clinical nutrition in neurology 2 found that patients with Parkinson's disease are at increased risk of malnutrition and weight loss, and that nutritional status should be monitored routinely throughout the natural history of the disease.
- The study also found that dysphagia in Parkinson's disease usually occurs in the advanced phases of the disease, and that functional alterations in oropharyngeal and esophageal motility can be present in about 60-80% of patients.
Other Interventions
Other interventions that have been explored in Parkinson's disease research include thermal-tactile stimulation, surface electrical stimulation, and repetitive transcranial magnetic stimulation.
- A 2018 study by the ESPEN guideline clinical nutrition in neurology 3 found that these interventions may be effective in improving swallow timing and reducing pharyngeal transit time, but more research is needed to confirm their efficacy.
Conclusion is not allowed, so the answer will be ended here.
From the FDA Drug Label
The effectiveness of pramipexole dihydrochloride tablets in the treatment of Parkinson's disease was evaluated in a multinational drug development program consisting of seven randomized, controlled trials Three were conducted in patients with early Parkinson's disease who were not receiving concomitant levodopa, and four were conducted in patients with advanced Parkinson's disease who were receiving concomitant levodopa Among these seven studies, three studies provide the most persuasive evidence of pramipexole's effectiveness in the management of patients with Parkinson's disease who were and were not receiving concomitant levodopa Two of these three trials enrolled patients with early Parkinson's disease (not receiving levodopa), and one enrolled patients with advanced Parkinson's disease who were receiving maximally tolerated doses of levodopa.
The recent developments in Parkinson's disease research, as per the provided drug labels, include the evaluation of pramipexole and entacapone in the treatment of Parkinson's disease.
- Pramipexole has been shown to be effective in the management of patients with Parkinson's disease, with or without concomitant levodopa, in several randomized, controlled trials.
- Entacapone has been evaluated as an adjunct to levodopa in the treatment of Parkinson's disease, and has been shown to increase "on" time and reduce "off" time in patients with motor fluctuations. Key findings include:
- Improved motor function: Pramipexole has been shown to improve motor function in patients with early and advanced Parkinson's disease.
- Increased "on" time: Entacapone has been shown to increase "on" time and reduce "off" time in patients with motor fluctuations.
- Reduced levodopa dose: Entacapone has been shown to allow for a reduction in levodopa dose in some patients. Overall, these findings suggest that pramipexole and entacapone may be useful treatments for patients with Parkinson's disease, particularly those with motor fluctuations or who are experiencing "on" and "off" periods 4, 5, 6.
From the Research
Recent Developments in Parkinson's Disease Research
- Current pharmacological treatments for Parkinson's disease (PD) include dopamine replacement therapy, such as levodopa and other dopaminergic drugs, as well as non-dopaminergic approaches like zonisamide and istradefylline 7.
- Device-aided therapies, including deep brain stimulation and levodopa-carbidopa intestinal gel infusion therapy, are also available for advanced stages of PD 7.
- Catechol-O-methyltransferase (COMT) inhibitors, such as entacapone, opicapone, and tolcapone, are used to improve the pharmacokinetics of levodopa and reduce motor fluctuations in patients with advanced PD 8, 9.
- COMT inhibitors have been shown to be effective in reducing off-time and improving motor symptoms in patients with PD, with entacapone and opicapone being considered first-line choices 9.
- Levodopa remains the most potent dopaminergic therapy for PD, and recent developments aim to achieve continuous delivery of levodopa, including duodenal infusion and transdermal patches 10.
- Emerging experimental therapies for PD are being developed to address the limitations of current treatments, including motor fluctuations and non-motor symptoms 11.
Pharmacological Treatments
- Dopaminergic pharmacotherapy for PD consists of levodopa and other dopaminergic drugs, such as dopamine agonists and monoamine oxidase B (MAOB) inhibitors 7.
- Non-dopaminergic pharmacological approaches, including zonisamide and istradefylline, are available for patients with PD 7.
- COMT inhibitors, such as entacapone and opicapone, are used to improve the pharmacokinetics of levodopa and reduce motor fluctuations in patients with advanced PD 9.
Device-Aided Therapies
- Deep brain stimulation is a device-aided therapy available for advanced stages of PD 7.
- Levodopa-carbidopa intestinal gel infusion therapy is another device-aided therapy available for patients with advanced PD 7.
Future Directions
- Emerging experimental therapies for PD are being developed to address the limitations of current treatments, including motor fluctuations and non-motor symptoms 11.
- Recent developments in treatment with levodopa aim to achieve continuous delivery of levodopa, including duodenal infusion and transdermal patches 10.