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Entacapone May Help Prolong Levodopa's Effect On Parkinson's Disease: Presented at AAN

BASEL, SWITZERLAND -- April 19, 2002 -- Important new evidence in Parkinson's disease now shows that entacapone in combination with levodopa can provide a more continuous, physiological stimulation of the dopamine receptors, which not only rapidly improves symptom control, but can also significantly reduce the development of dyskinesia in the long-term.

Levodopa (L-DOPA) is deservedly the mainstay and most effective Parkinson's disease treatment. However, when used long-term, current levodopa therapy can be associated with the development of motor complications, including dyskinesias and wearing-off phenomena.

The new data, presented for the first time at the American Academy of Neurology (AAN) congress, Denver, Colorado, demonstrate the potential of this levodopa/entacapone combination for the effective long-term management of Parkinson's disease patients from treatment initiation. Entacapone extends the half life of each levodopa dose and ensures a more continuous delivery of dopamine.

Recent findings using a primate model of Parkinson's disease have shown that, compared with levodopa alone, co-administration of entacapone with levodopa not only enhances parkinsonian symptom control by consistently improving daily locomotor activity, but, in the long-term, also avoids the induction of dyskinesias. MPTP-treated primates were used as the animal model of choice because the dyskinesias that occur in these animals following chronic intermittent administration of levodopa closely resemble those observed in clinical Parkinson's disease.

Commenting on the clinical relevance of these data, its author, Professor Peter Jenner, Director of the Neurodegenerative Diseases Research Centre, of King's College London said "We have shown for the first time that by providing a more continuous stimulation of striatal dopamine receptors, the combination of levodopa and entacapone has the potential to avoid the development of dyskinesias. This supports the notion that levodopa continuous dopaminergic stimulation is important for preventing the priming effect that underlies involuntary movements in Parkinson's disease".

Physicians are increasingly concerned that long-term, non-physiological pulsatile stimulation of dopamine receptors with standard levodopa formulations or with other short acting dopaminergic therapies may, at least in part, be responsible for the development of dyskinesias, as well as motor fluctuations. The present data strongly suggest that administration of the levodopa/entacapone combination, currently used to treat fluctuating patients who are experiencing wearing-off, may provide an effective means of treating Parkinson's disease from the early stages of the disease, with the potential to avoid the induction of motor complications in the long-term. Orion Pharma and Novartis are undertaking clinical studies to verify that these results are also seen in Parkinson's disease patients. One study has already been initiated with de-novo patients, which will aim to highlight symptomatic benefits.

SOURCE: Novartis AG

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