“The big challenge in Parkinson—with levodopa really being the main therapy that most patients end up on to one degree or another—is that levodopa only has a 90-minute half-life in the bloodstream. So, it really doesn’t last very long, and even though early on patients can take it 5 or 6 hours apart, in advanced disease it lasts closer to 90 minutes.”

The movement disorder space, particularly within Parkinson disease, has had a recent boom in treatments for fluctuations in on times as well as dyskinesias. While levodopa has been the gold standard for some time, as patients progress further along the disease course, the time the medication takes to wear off decreases, and thus the need to bridge the gaps between becomes more pertinent.

As movement disorder specialists such as Benjamin Walter, MD, medical director, Deep Brain Stimulation Program, Cleveland Clinic, know all too well, this has been the focus of much of the field’s drug development in the last few years. The introduction of more agents has made this time an exciting one, Walter said.

In an interview with NeurologyLive, Walter explained the current state of affairs in the Parkinson disease treatment paradigm, as well as what challenges remain to be addressed and how he and his peers are working to continue along a path of improvement.