What is istradefylline (adenosine A2A receptor antagonist)?

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Last updated: April 4, 2025View editorial policy

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From the Guidelines

Istradefylline is not mentioned in the provided evidence, and therefore, its use cannot be recommended based on the given guidelines. However, adenosine, which is related to istradefylline in terms of its mechanism of action as an adenosine receptor antagonist, is discussed in several studies 1. The provided evidence focuses on various medical conditions, including atopic dermatitis, asthma, obesity, coronary artery disease, and supraventricular tachycardia, but does not provide information on istradefylline. Some key points from the evidence include:

  • The use of adenosine as a vasodilator in the assessment of coronary artery disease 1
  • The role of adenosine in the management of supraventricular tachycardia 1
  • The use of ivabradine, a medication that affects the heart rate, in the management of inappropriate sinus tachycardia 1 It's essential to consult the most recent and relevant guidelines for the use of istradefylline in clinical practice.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Istradyfylline Overview

  • Istradefylline is an adenosine A2A receptor antagonist used in the treatment of Parkinson's disease (PD) 2, 3, 4, 5, 6.
  • It is indicated as an adjunctive treatment to levodopa/carbidopa in patients experiencing "off episodes" 5.

Efficacy and Safety

  • Istradefylline has been shown to decrease "off" time in patients with PD receiving optimal dopaminergic therapy 2, 3, 4, 5, 6.
  • It has also been demonstrated to improve motor function without worsening dyskinesia 2, 3.
  • The results of a systematic review and meta-analysis suggest that istradefylline exhibits an efficient and well-tolerated role in treating PD patients, with a significant difference in efficacy and decreasing OFF time compared to placebo 6.

Potential Benefits

  • Istradefylline may also have a role in treating non-motor symptoms (NMS) and cognitive decline in PD patients 4.
  • It has been suggested that istradefylline may have neuroprotective effects, although further studies are needed to investigate this potential benefit 3, 4.

Clinical Use

  • Istradefylline has completed phase III development and is marketed for the treatment of PD 2.
  • It is an important option for patients with advanced PD, where it has been demonstrated to be effective in decreasing daily OFF time and is well tolerated 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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