Transdermal lisuride delivery in the treatment of Parkinson’s disease

  • D. Woitalla
  • T. Müller
  • S. Benz
  • R. Horowski
  • H. Przuntek
Chapter
Part of the Journal of Neural Transmission. Supplementa book series (NEURAL SUPPL, volume 68)

Summary

Transdermal delivery of dopamine agonists (DA) is a promising therapeutic concept, which aims to ameliorate frequency and intensity of motor fluctuations in patients with Parkinson’s disease (PD). We treated 8 PD patients with unpredictable on-off phenomena with lisuride patches (release: 2–5/μg lisuride base/cm2/hour in mice) in addition to their preexisting antiparkinsonian drug regime up to a period of 8 days. In order to quantify the intensity and frequency of motor fluctuations, we determined the motor changing rate (MCR), which corresponds to the patient’s self rating of motor function, performed every thirty minutes, divided through the number of scored intervals minus 1. Additional lisuride patch application significantly (p = 0.023) improved the MCR compared to baseline. Relevant side effects were transient skin irritations in four patients. Our observational study demonstrates the safety, tolerability and efficacy of transdermal lisuride delivery in the treatment of motor complications.

Keywords

Dopamine Agonist Motor Fluctuation Motor Complication Therapeutic Concept Antiparkinsonian Drug 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. Baas H, Harder S, Demisch L, Burklin F, Stecker K, Fischer PA (1995) Fluctuations in Parkinson’s disease. Pathogenetic significance of levodopa’s cerebral pharmacokinetics and pharmacodynamics. J Neural Transm [Suppl] 46: 367–379Google Scholar
  2. Behrens S, Sommerville K (2003) Non-oral drug delivery in Parkinson’s disease: a summary from the symposium at the 7th International Congress of Parkinson’s Disease and Movement Disorders, 10-14 November 2002, Miami, FL, USA. Expert Opin Pharmacother 4: 595–599PubMedCrossRefGoogle Scholar
  3. Danhof M, van der Geest R, van Laar T, Bodde HE (1998) An integrated pharmacokinetic-pharmacodynamic approach to optimization of R-apomorphine delivery in Parkinson’s disease. Adv Drug Delivery Rev 33: 253–263CrossRefGoogle Scholar
  4. Deleu D, Northway MG, Hanssens Y (2002) Clinical pharmacokinetic and pharmacodynamic properties of drugs used in the treatment of Parkinson’s disease. Clin Pharmacokinet 41: 261–309PubMedCrossRefGoogle Scholar
  5. Hoehn MM, Yahr MD (2001) Parkinsonism: onset, progression, and mortality. 1967. Neurology 57: S11–S26PubMedGoogle Scholar
  6. Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinic al diagnosis of idiopathic Parkinson’ s disease: a clinico-pathological study of 100 case s [see comments]. J Neurol Neurosurg Psychiatry 55: 181–184PubMedCrossRefGoogle Scholar
  7. Metman LV, Gillespie M, Fanner C, Bibbiani F, Konitsiotis S, Morris M, Shill H, Bara-Jimenez W Mouradian MM, Chase TN (2001) Continuous transdennal dopaminergic stimulation in advanced Parkinson’s disease. Clin Neurophannacol 24: 163–169CrossRefGoogle Scholar
  8. Montastruc JL, Ziegler M, Rascol O, Malbezin M (1999) A randomized, double-blind study of a skin patch of a dopaminergic agonist, piribedil, in Parkinson’s disease. Mov Disord 14: 336–341PubMedCrossRefGoogle Scholar
  9. Müller T (2002) Dopaminergic substitution in Parkinson’s disease. Expert Opin Phannacother 3: 1393–1403CrossRefGoogle Scholar
  10. Pfeiffer RF (2002) Potential oftransdennal drug delivery in Parkinson’s disease. Drugs & Aging 19: 561–570CrossRefGoogle Scholar
  11. Poewe WH, Deuschl G, Gordin A, Kultalahti ER, Leinonen M (2002 ) Efficacy and safety of entacapone in Parkinson’s disease patients with suboptimal levodopa response: a 6-month randomized placebo-controlled double-blind study in Germany and Austria (Celomen study). Acta Neurol Scand 105: 245–255PubMedCrossRefGoogle Scholar
  12. Rinne UK (1999 ) [Combination therapy with lisuride and L-dopa in the early stages of Parkin son’s disease decreases and delays the development of motor fluctuation s. Long-term study over 10 years in comparison with L-dopa monotherapy]. Nervenarzt 70[Suppl 1]: S19–S25PubMedCrossRefGoogle Scholar
  13. Sudo J, Iwase H, Terui J, Kakuno K, Soyama M, Takayama K, Nagai T (1998 ) Transdennal absorption of L-dopa from hydrogel in rats. Eur J Pharmaceut Sci 7: 67–71CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2004

Authors and Affiliations

  • D. Woitalla
    • 1
  • T. Müller
    • 1
  • S. Benz
    • 1
  • R. Horowski
    • 2
  • H. Przuntek
    • 1
  1. 1.Department of Neurology, St. Josef Hospital Ruhr University BochumBochumGermany
  2. 2.NeuroBiotec BerlinBerlinGermany

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