Jeffrey Ratliff, MD: Reducing Off Time in Parkinson Disease


The neurologist at Thomas Jefferson University Hospitals discussed the pros and cons of supplemental drugs used to reduce off time in patients with Parkinson disease.

“I think the holy grail outside of disease modifying therapy is ‘Can we come up with a way to keep dopaminergic therapy steady and at a satisfactory level throughout the day?”

For nearly 50 years, Parkinson disease (PD) has been treated with carbidopa-levodopa. While an effective medication that helps treat symptoms of PD, drawbacks to the therapy continue to persist.

Patients with PD may experience off time, a period in which the drug wears off and disabling disease symptoms reemerge. Supplementary therapies can be used to reduce off time in between carbidopa-levodopa doses; however these medications have their own benefits and drawbacks. Drugs such as apomorphine are effective, but many patients may be unwilling to use an injection-based drug. Other supplemental drugs such as Parcopa decrease off time and may be more favorable among patients since it is an oral medication; however, gut absorption rates may impact relief time.

In an interview with NeurologyLive, Ratliff outlined the landscape of supplemental drugs that can decrease off time for patients with PD, as well as the conscious goal to continue to improve these therapies and their mode of administration while continuing efforts to identify a disease-modifying drug breakthrough.

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