Robert Hauser, MD, MBA, discussed unmet needs and future consideration in Parkinson disease.
Robert Hauser, MD, MBA: [With] some of the other newer treatments, we have to try to smooth [out] and maintain good ON time through the day. Include long-acting carbidopa/levodopa oral preparations. There are a number of subcutaneous infusions, both APRIL morphine and levodopa-based infusions that are in development, and we also have surgeries, including deep brain stimulation. But we still are in need of a simple, really well-tolerated therapy that will start quickly first-thing in the morning or be on board when the patient wakes up in the morning and maintain that therapy and good benefit through the day. I don’t think we have that yet. I think we’ve made good progress. We have a number of different therapies that we can apply, but we’re still looking for some way, perhaps an oral medication, that will get started really quickly in the morning and maintain a really good long duration of benefit. I’m hoping for 8 to 10 hours or more. So we still are missing that kind of medication yet.
I think a different approach to having patients maintain good benefits through the day is trying to keep them in the earlier phases of Parkinson disease longer. And this gets into the whole idea of slowing progression of Parkinson disease. We’re entering a whole new phase of evaluating new medications and doing clinical trials to see if we can slow [the] progression of Parkinson disease and if we can maintain dopamine neurons longer, and the ability of these neurons to uptake levodopa, convert it to [stored] dopamine…and slowly release it over time, for longer through the disease. Maybe instead of patients having these kinds of motor fluctuations of dyskinesia problems 8 to 10 years from diagnosis, if we can double that and make it 16 to 20 years from diagnosis, that would help a lot of patients.
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