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New Clinical Trials for Levodopa-Induced Dyskinesia

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Levodopa-Induced Dyskinesia in Parkinson's Disease

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Abstract

Ongoing clinical trials are looking at new strategies for treatment of levodopa-induced dyskinesia (LID). While the pathophysiology of LID is still not completely understood, preclinical studies have provided more insights into the underlying mechanisms. To date, however, translation to human therapeutic trials has generally been disappointing. Two main therapeutic strategies are recognized: (1) agents that may prevent the development of dyskinesia and can be used in early PD and (2) interventions that reduce established dyskinesia in advanced PD.

As LID are thought to relate to chronic pulsatile stimulation of dopamine receptors, continuous dopaminergic stimulation might reduce established dyskinesia and possibly prevent or delay the appearance. Ongoing clinical trials are investigating novel dopamine preparations with a more stable delivery that might also allow reductions in oral levodopa. The effect of levodopa-sparing agents on LID is also being investigated, both in early and advanced PD. Moreover, non-dopaminergic agents are being studied as add-on therapies in established LID. Such agents are also being studied in early PD, either as monotherapy to improve parkinsonian symptoms without causing dyskinesia or as add-on treatments to prevent development of dyskinesia in levodopa-treated patients.

In this chapter, we will review recently published and ongoing Phase II–IV clinical trials for the treatment of LID. As the research field is constantly evolving, this chapter will be updated regularly through a website (LINK), which will include a database of ongoing studies and recent results from clinical trials. This is meant to be a practical tool for the clinician to follow new developments in the field of LID treatment and to have an easy access to information on ongoing trials.

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  1. Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada

    Susan H. Fox & Isabelle Boileau-Boire

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  1. Susan H. Fox
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  1. Toronto Western Hospital, Toronto, Ontario, Canada

    Susan H. Fox

  2. Toronto Western Hospital, Toronto, Ontario, Canada

    Jonathan M. Brotchie

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Fox, S.H., Boileau-Boire, I. (2014). New Clinical Trials for Levodopa-Induced Dyskinesia. In: Fox, S., Brotchie, J. (eds) Levodopa-Induced Dyskinesia in Parkinson's Disease. Springer, London. https://doi.org/10.1007/978-1-4471-6503-3_17

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  • DOI: https://doi.org/10.1007/978-1-4471-6503-3_17

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