Latest News in Parkinson Disease: Addressing Motor Issues and Dyskinesia, Progression to Advanced Disease, and More

An overview of the latest news in Parkinson disease (PD) reported across MJH Life Sciences^™.

Amantadine Found to Improve Motor Function, Dyskinesia in PD

According to results from 2 randomized phase 3 trials, amantadine extended-release capsules, sold as Gocovri, were associated with significant improvements in dyskinesia and motor aspects of experiences of living (M-EDLs) in people with PD.

As reported by NeurologyLive^®, participants with PD who had been taking levodopa for 7.7 years and experiencing dyskinesia for 3.8 years were randomized to receive either amantadine or placebo across a 12-week period. Analyzed via the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, changes from baseline to week 12 showed a treatment difference of –2.0 (P = .004) for amantadine vs placebo, with the intervention group’s change from baseline exceeding a published minimal clinically important difference threshold of 3.05 points.

Moreover, participants of the intervention group showcased significant improvements in several M-EDLs, including freezing of gait; tremor; getting up from bed, chairs, and deep seats; and eating tasks. Amantadine is currently the only approved therapy in the United States to treat both OFF episodes and dyskinesia in patients with PD.

Progression of Advanced PD May Affect Treatment

In a Peer Exchange series by NeurologyLive^®, titled, “Recognizing and Managing Advanced Parkinson Disease,” panelists discussed the natural progression of PD from initial diagnosis to advanced disease.

Highlighting the heterogeneity of the condition, there are several signs of advanced PD, particularly waning efficacy of treatments. Along with other signs of disease progression, such as newfound tremors or mood changes, panelists noted that as PD advances, symptoms become more difficult to treat with medications.

Speaking on the optimal time to start medications or integrate novel management strategies, including speech therapy and exercise, they said that when symptoms are disabling and have a clear impact on a patient’s functionality and quality of life, interventions should be implemented.

Spotlighting Prescription of Dementia-Linked Medications

Based on study findings published in Journal of the American Geriatrics Society, alerts sent via electronic health records (EHRs) to reduce the prescribing of high-risk medications associated with dementia in older adults were more than likely to remain unread in primary care sites.

Focusing on anticholinergics, which affect the brain by blocking a nervous system neurotransmitter that influences memory and alertness, called acetylcholine, the study authors noted these drugs have been linked with dementia. However, they are prescribed for many conditions in older adults, including PD, which may increase risk of dementia in an already at-risk patient population.

Notably, 85% of EHR alerts to providers and 95% of alerts to medical assistants about the risk posed by anticholinergic medications went unread. In improving education and methods of communication with primary care providers, human-based strategies or a policy-based component were cited to reduce use of high-risk medications.