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Non-oral dopaminergic therapies for Parkinson's disease: current treatments and the future.
NPJ Parkinsons Dis. 2016; 2:16023.NP

Abstract

Dysfunction of the gastrointestinal tract has now been recognized to affect all stages of Parkinson's disease (PD). The consequences lead to problems with absorption of oral medication, erratic treatment response, as well as silent aspiration, which is one of the key risk factors in developing pneumonia. The issue is further complicated by other gut abnormalities, such as small intestinal bacterial overgrowth (SIBO) and an altered gut microbiota, which occur in PD with variable frequency. Clinically, these gastrointestinal abnormalities might be associated with symptoms such as nausea, early-morning "off", and frequent motor and non-motor fluctuations. Therefore, non-oral therapies that avoid the gastrointestinal system seem a rational option to overcome the problems of oral therapies in PD. Hence, several non-oral strategies have now been actively investigated and developed. The transdermal rotigotine patch, infusion therapies with apomorphine, intrajejunal levodopa, and the apomorphine pen strategy are currently in clinical use with a few others in development. In this review, we discuss and summarize the most recent developments in this field with a focus on non-oral dopaminergic strategies (excluding surgical interventions such as deep brain stimulation) in development or to be licensed for management of PD.

Authors+Show Affiliations

National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, UK. Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King's College, London, UK.National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, UK. Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King's College, London, UK.National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, UK. Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King's College, London, UK.National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, UK. Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King's College, London, UK. Department of Neurology, University Hospital Cologne, Cologne, Germany.National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, UK. Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King's College, London, UK.Department of Neurology, Lund University, Skane University Hospital, Lund, Sweden. Klinikum-Bremerhaven, Bremerhaven, Germany.Neurodegenerative Diseases Research Group, Institute of Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28725704

Citation

Ray Chaudhuri, K, et al. "Non-oral Dopaminergic Therapies for Parkinson's Disease: Current Treatments and the Future." NPJ Parkinson's Disease, vol. 2, 2016, p. 16023.
Ray Chaudhuri K, Qamar MA, Rajah T, et al. Non-oral dopaminergic therapies for Parkinson's disease: current treatments and the future. NPJ Parkinsons Dis. 2016;2:16023.
Ray Chaudhuri, K., Qamar, M. A., Rajah, T., Loehrer, P., Sauerbier, A., Odin, P., & Jenner, P. (2016). Non-oral dopaminergic therapies for Parkinson's disease: current treatments and the future. NPJ Parkinson's Disease, 2, 16023. https://doi.org/10.1038/npjparkd.2016.23
Ray Chaudhuri K, et al. Non-oral Dopaminergic Therapies for Parkinson's Disease: Current Treatments and the Future. NPJ Parkinsons Dis. 2016;2:16023. PubMed PMID: 28725704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-oral dopaminergic therapies for Parkinson's disease: current treatments and the future. AU - Ray Chaudhuri,K, AU - Qamar,Mubasher A, AU - Rajah,Thadshani, AU - Loehrer,Philipp, AU - Sauerbier,Anna, AU - Odin,Per, AU - Jenner,Peter, Y1 - 2016/12/01/ PY - 2016/05/23/received PY - 2016/07/07/revised PY - 2016/08/25/accepted PY - 2017/7/21/entrez PY - 2017/7/21/pubmed PY - 2017/7/21/medline SP - 16023 EP - 16023 JF - NPJ Parkinson's disease JO - NPJ Parkinsons Dis VL - 2 N2 - Dysfunction of the gastrointestinal tract has now been recognized to affect all stages of Parkinson's disease (PD). The consequences lead to problems with absorption of oral medication, erratic treatment response, as well as silent aspiration, which is one of the key risk factors in developing pneumonia. The issue is further complicated by other gut abnormalities, such as small intestinal bacterial overgrowth (SIBO) and an altered gut microbiota, which occur in PD with variable frequency. Clinically, these gastrointestinal abnormalities might be associated with symptoms such as nausea, early-morning "off", and frequent motor and non-motor fluctuations. Therefore, non-oral therapies that avoid the gastrointestinal system seem a rational option to overcome the problems of oral therapies in PD. Hence, several non-oral strategies have now been actively investigated and developed. The transdermal rotigotine patch, infusion therapies with apomorphine, intrajejunal levodopa, and the apomorphine pen strategy are currently in clinical use with a few others in development. In this review, we discuss and summarize the most recent developments in this field with a focus on non-oral dopaminergic strategies (excluding surgical interventions such as deep brain stimulation) in development or to be licensed for management of PD. SN - 2373-8057 UR - https://www.unboundmedicine.com/medline/citation/28725704/Non-oral_dopaminergic_therapies_for_Parkinson's_disease:_current_treatments_and_the_future L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28725704/ DB - PRIME DP - Unbound Medicine ER -
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