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Profile of inhaled levodopa and its potential in the treatment of Parkinson’s disease: evidence to date

Authors Patel AB, Jimenez-Shahed J

Received 18 May 2018

Accepted for publication 20 September 2018

Published 2 November 2018 Volume 2018:14 Pages 2955—2964


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Roger Pinder

Ami B Patel, Joohi Jimenez-Shahed

Department of Neurology, Baylor College of Medicine, Houston, TX, USA

Abstract: Inhaled levodopa is a newly emerging therapeutic option in the treatment of “off” symptoms associated with Parkinson’s disease (PD). Its mode of delivery offers more rapid absorption of levodopa and shorter onset of clinical benefit compared to oral formulations, and has been shown to be feasible for use in patients with PD experiencing worse motor function due to declining plasma levodopa levels. Clinical development of this compound is supported by preclinical, Phase I–III, long-term-safety studies and studies in special populations, including otherwise-healthy asthmatics and smokers. These investigations demonstrated that the drug is well tolerated without risk of long-term (up to 1 year) changes in pulmonary function or spirometry measures. The most common side effects among PD patients were a mild cough, upper respiratory tract infection, nausea, sputum discoloration, and dyskinesia. Inhaled levodopa offers a different administration method and side-effect profile from the currently available options for rescue therapy for Off periods in PD, though comparative studies have not been performed. The drug is presently under review by the US Food and Drug Administration.

Keywords: levodopa, dry-powder inhalation, motor fluctuations, dyskinesia, spirometry

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