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Abstract
Parkinson disease (PD) is a slowly progressive, incurable, neurodegenerative disorder with progressive motor symptoms that can be managed with treatments. Levodopa is generally recognized as the most effective and widely used treatment for PD. It improves function and quality of life, morbidity, and mortality, and therefore reduces individual and societal costs. Levodopa has a relatively short half-life, however, and is quickly metabolized in the plasma, leading to fluctuations, including wearing-off of effect and inconsistent symptomatic relief as well as development of dyskinesias, with both wearing off and dyskinesias worsening with advancing disease. Immediate-release and controlled-release formulations have been used with success, but motor fluctuations remain a problem. RYTARY (levodopa and carbidopa, IPX066) is an oral extended-release therapy composed of carbidopa–levodopa microbeads designed to dissolve at various rates that allows for quick absorption and sustained levodopa release over an extended period. In development studies, RYTARY improved symptoms in patients with both early and advanced PD and offered significantly improved Unified Parkinson Disease Rating Scale scores and “on” times, without worsening troublesome dyskinesias when compared to other levodopa formulations. Tolerability and safety were comparable to other formulations. This section reviews the data that support the use of RYTARY in the treatment of PD.
GLOSSARY
- ADVANCE-PD=
- A Study to Evaluate the Safety and Efficacy of IPX066 in Advanced Parkinson's Disease;
- AE=
- adverse event;
- APEX-PD=
- A Study to Evaluate the Safety and Efficacy of IPX066 in Subjects with Parkinson's Disease;
- ASCEND-PD=
- Comparison of IPX066, a Novel Carbidopa-Levodopa Extended-Release Formulation, and CD-LD-Entacapone in Advanced Parkinson's Disease;
- CD=
- carbidopa;
- CGI-C=
- Clinician Global Impression of Change;
- CLE=
- carbidopa-levodopa + entacapone;
- CR=
- controlled release;
- DDC=
- dopa decarboxylase;
- EQ-5D=
- EuroQoL 5-dimension quality of life scale;
- FDA=
- Food and Drug Administration;
- IR=
- immediate release;
- LD=
- levodopa;
- PDQ-39=
- 39-item Parkinson's Disease Questionnaire;
- PD=
- Parkinson disease;
- PGI-C=
- Patient Global Impression of Change;
- PK=
- pharmacokinetics;
- SAE=
- serious adverse event;
- SF-36=
- Short Form Health Survey;
- UPDRS=
- Unified Parkinson's Disease Rating Scale
Footnotes
Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
This Neurology® supplement was not peer-reviewed. Information contained in this Neurology supplement represents the opinions of the authors. These opinions are not endorsed by nor do they reflect the views of the American Academy of Neurology, Editor-in-Chief, or Associate Editors of Neurology.
- © 2016 American Academy of Neurology
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