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Factors associated with motor fluctuations and dyskinesia in Parkinson Disease: potential role of a new melevodopa plus carbidopa formulation (Sirio).
Clin Neuropharmacol. 2010 Jul; 33(4):198-203.CN

Abstract

Parkinson disease is a progressive movement disorder caused by loss of dopaminergic neurons in the substantia nigra. Of unknown etiology, Parkinson disease is characterized by 4 cardinal symptoms: tremor at rest, bradykinesia, postural instability, and rigidity. The current criterion-standard drug used in the management of parkinsonian symptoms is levodopa (l-dopa). However, long-term l-dopa therapy is associated with the development of motor complications; approximately 50% to 80% of patients will develop motor complications within 5 to 10 years of l-dopa treatment initiation. Motor complications can be divided into motor fluctuations, caused largely through pulsatile dopamine stimulation and low l-dopa concentrations, and dyskinesia, associated more often with peak l-dopa concentrations. Ultimately, the main goal was to provide steady l-dopa concentrations, without peaks and troughs. Empirical investigations using parenteral infusions of l-dopa and highly soluble l-dopa prodrugs have shown that there is benefit in ameliorating the peaks and troughs associated with traditional oral l-dopa formulations. Recently, the development of highly soluble oral l-dopa prodrugs has facilitated rapid, regular, and reliable l-dopa availability. This review evaluates some of the pharmacologic strategies in the management of motor complications in Parkinson disease and therapy optimization, with a focus on the use of CHF 1512 (Sirio), a combination of melevodopa (l-dopa methylester, a highly soluble prodrug of l-dopa) plus carbidopa in an effervescent tablet formulation.

Authors+Show Affiliations

IRCCS San Raffaele Pisana, Rome; and daggerMedical Department, Chiesi Farmaceutici S.p.A., Parma, Italy. stocchi@sanraffaele.itNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

20414107

Citation

Stocchi, Fabrizio, and Stefano Marconi. "Factors Associated With Motor Fluctuations and Dyskinesia in Parkinson Disease: Potential Role of a New Melevodopa Plus Carbidopa Formulation (Sirio)." Clinical Neuropharmacology, vol. 33, no. 4, 2010, pp. 198-203.
Stocchi F, Marconi S. Factors associated with motor fluctuations and dyskinesia in Parkinson Disease: potential role of a new melevodopa plus carbidopa formulation (Sirio). Clin Neuropharmacol. 2010;33(4):198-203.
Stocchi, F., & Marconi, S. (2010). Factors associated with motor fluctuations and dyskinesia in Parkinson Disease: potential role of a new melevodopa plus carbidopa formulation (Sirio). Clinical Neuropharmacology, 33(4), 198-203. https://doi.org/10.1097/WNF.0b013e3181de8924
Stocchi F, Marconi S. Factors Associated With Motor Fluctuations and Dyskinesia in Parkinson Disease: Potential Role of a New Melevodopa Plus Carbidopa Formulation (Sirio). Clin Neuropharmacol. 2010;33(4):198-203. PubMed PMID: 20414107.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with motor fluctuations and dyskinesia in Parkinson Disease: potential role of a new melevodopa plus carbidopa formulation (Sirio). AU - Stocchi,Fabrizio, AU - Marconi,Stefano, PY - 2010/4/24/entrez PY - 2010/4/24/pubmed PY - 2010/12/14/medline SP - 198 EP - 203 JF - Clinical neuropharmacology JO - Clin Neuropharmacol VL - 33 IS - 4 N2 - Parkinson disease is a progressive movement disorder caused by loss of dopaminergic neurons in the substantia nigra. Of unknown etiology, Parkinson disease is characterized by 4 cardinal symptoms: tremor at rest, bradykinesia, postural instability, and rigidity. The current criterion-standard drug used in the management of parkinsonian symptoms is levodopa (l-dopa). However, long-term l-dopa therapy is associated with the development of motor complications; approximately 50% to 80% of patients will develop motor complications within 5 to 10 years of l-dopa treatment initiation. Motor complications can be divided into motor fluctuations, caused largely through pulsatile dopamine stimulation and low l-dopa concentrations, and dyskinesia, associated more often with peak l-dopa concentrations. Ultimately, the main goal was to provide steady l-dopa concentrations, without peaks and troughs. Empirical investigations using parenteral infusions of l-dopa and highly soluble l-dopa prodrugs have shown that there is benefit in ameliorating the peaks and troughs associated with traditional oral l-dopa formulations. Recently, the development of highly soluble oral l-dopa prodrugs has facilitated rapid, regular, and reliable l-dopa availability. This review evaluates some of the pharmacologic strategies in the management of motor complications in Parkinson disease and therapy optimization, with a focus on the use of CHF 1512 (Sirio), a combination of melevodopa (l-dopa methylester, a highly soluble prodrug of l-dopa) plus carbidopa in an effervescent tablet formulation. SN - 1537-162X UR - https://www.unboundmedicine.com/medline/citation/20414107/Factors_associated_with_motor_fluctuations_and_dyskinesia_in_Parkinson_Disease:_potential_role_of_a_new_melevodopa_plus_carbidopa_formulation__Sirio__ DB - PRIME DP - Unbound Medicine ER -