Are Adenosine A2A Antagonists Making a Comeback for Parkinson Disease?

A phase II trial of tozadenant revives consideration of this treatment approach.

Excitement over the potential use of adenosine A2A antagonists in the treatment of Parkinson disease (PD) quieted after a few disappointing trials. A newer A2A antagonist, tozadenant (SYN115), has reopened the door for discussion of this novel treatment approach. Researchers have now conducted a manufacturer-funded, phase IIb, randomized, double-blind, placebo-controlled, parallel-group study. The aims were to address the use of tozadenant add-on therapy to reduce levodopa-induced motor fluctuations, optimize dosing for future studies, and assess effectiveness and safety. Patients had to have motor fluctuations and 2.5 hours/day of off time. For 3 months, patients received either tozadenant (60, 120, 180, or 240 mg) or matching placebo twic…

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)