Adjunctive Therapies in Parkinson’s Disease: How to Choose the Best Treatment Strategy Approach View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-12

AUTHORS

Margherita Fabbri, Mario M. Rosa, Joaquim J. Ferreira

ABSTRACT

End-of-dose motor fluctuations are regarded as one of the core troublesome symptoms by patients with Parkinson's disease (PD). Treatment of levodopa (L-dopa)-induced motor fluctuations is still an unmet medical need. L-dopa is the gold standard in the treatment of motor PD symptoms; notwithstanding, a wide range of adjunct therapies are currently available for the treatment of end-of-dose motor fluctuations. Additionally, device-aided therapies, such as deep brain stimulation, L-dopa-carbidopa intestinal gel infusion, and on-demand injection or continuous apomorphine infusion, may be considered when oral treatments are not sufficient to control motor fluctuations. In spite of the several evidence-based reviews and guidelines available, there is no agreement on which add-on therapy should be started first or its optimal timing. Equally challenging is the choice and timing between device-aided therapies. Herein, we propose a general overview of oral and device-aided treatments for PD patients with end-of-dose motor fluctuations, offering two possible algorithms that can guide clinicians during the therapeutic decision process. More... »

PAGES

1-14

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s40266-018-0599-2

DOI

http://dx.doi.org/10.1007/s40266-018-0599-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1107609024

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30318555


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