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Produodopa:
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As patients with advanced Parkinson's disease, we all have a common experience: the search for an effective treatment in an ever-changing therapeutic landscape. We originally relied on standard therapy with levodopa in combination with dopa decarboxylase inhibitors such as carbidopa or benserazide. However, over time, we all experienced decreasing effectiveness of this oral medication, characterized by more frequent fluctuations in effectiveness, alternating between periods of good (on) and poor (off) effectiveness.
Some of us tried the available pump procedures, in which intestinal gels such as Duodopa® or Lecigon® are infused directly into the small intestine. However, this method required a probe and therefore a surgical procedure, which was a major hurdle for many of us.
However, the perspectives changed fundamentally with the introduction of Produodopa®, a subcutaneous infusion solution. Continuous infusion over 24 hours using a portable pump ensures more constant effective levels. The crucial advantage for all of us is that no surgery is required to insert the subcutaneous cannula. This less invasive treatment option is a huge relief for all of us.
Produodopa consists of levodopa monophosphate and carbidopa monophosphate in a water-soluble form, which improves absorption and effectiveness. The results of the phase III study are impressive and show that produodopa significantly increases the on time and shortens the off time without bothersome dyskinesia compared to oral levodopa/carbidopa medication.
Despite the side effects, such as reactions at the infusion site, I consider these to be a reasonable price to pay for the significantly improved quality of life. The subcutaneous infusion is easy to manage and it is possible to change the infusion site regularly to avoid complications.
Overall, I see Produodopa as a significant advance in the treatment of our disease. It offers us a more effective, less invasive and more flexible treatment method compared to previous pump procedures and oral medication.
Summary:
| Aspect | traditional Therapy (Oral levodopa/carbidopa, pump procedure) | Produodopa® therapy |
| Form of medication | Oral, intestinal gels via pump | Subcutaneous infusion solution |
| Required surgical intervention | Yes, for pump procedures | No |
| Duration of action | Varies, frequent on-off phases | More constant effective levels over 24 hours |
| application | Orally or infusion into the small intestine | Subcutaneous infusion, preferably into the abdominal cavity |
| Effectiveness in comparison | Declining efficiency, fluctuations in effectiveness | Significantly improved on time, reduced off time |
| Nebenwirkungen | Varies | Infusion site reactions, hallucinations, falls, anxiety |
| Patient comfort | Lower for pump processes | Higher through non-invasiveness and ease of use |
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My clinic informed me that the Produodopa pump is currently not available. is a general bottleneck to be expected?
Some friends of mine are currently receiving it.