Dopamine Pumps for Parkinson Disease: Has the Time Come?

A placebo-controlled trial shows better reduction of motor off-time with levodopa-carbidopa gel delivered via intrajejunal infusion than with oral therapy.

Oral treatments for Parkinson disease (PD) are limited mainly by the association with motor fluctuations and dyskinesia, leading to burgeoning interest in better, more continuous delivery strategies for advanced PD. In the trial, researchers tested the safety and efficacy of an intrajejunal levodopa–carbidopa intestinal gel infusion strategy that is investigational in the U.S. The manufacturer-sponsored, randomized, double-blind, double-dummy, double-titration trial was conducted at 26 centers in Germany, New Zealand, and the U.S. All participants underwent placement of a percutaneous gastrojejunostomy tube and were randomized 1:1 to either immediate-release oral levodopa-carbidopa or levodopa-carbidopa intestinal gel infusion, along with a…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)