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Neurology and Therapy
Published in: Neurology and Therapy 4/2023

Open Access 23-05-2023 | Parkinson's Disease | REVIEW

Clinical Use of On-Demand Therapies for Patients with Parkinson’s Disease and OFF Periods

Authors: Rajesh Pahwa, Fernando L. Pagan, Daniel E. Kremens, Marie Saint-Hilaire

Published in: Neurology and Therapy | Issue 4/2023

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Abstract

On-demand therapies for Parkinson’s disease (PD) provide rapid, reliable relief for patients experiencing OFF periods; however, practical guidelines on the use of these therapies are not generally available. This paper reviews the use of on-demand treatments. Motor fluctuations occur in nearly all patients with PD after long-term use of levodopa. As the goal of PD treatment is to provide good ON time, on-demand treatments that have a more rapid reliable onset than the slower-acting oral medications provide rapid relief for OFF periods. All current on-demand treatments bypass the gastrointestinal tract, providing dopaminergic therapy directly into the blood stream by subcutaneous injection, through the buccal mucosa, or by inhalation into the pulmonary circulation. On-demand treatments are fast acting (10- to 20-min onset), with maximum, reliable, and significant responses reached within 30 min after administration. Oral medications pass through the gastrointestinal tract and thus have slower absorption owing to gastroparesis and competition with food. On-demand therapies, by providing fast-acting relief, can have a positive impact on a patient’s quality of life when patients are experiencing OFF periods.
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Metadata
Title
Clinical Use of On-Demand Therapies for Patients with Parkinson’s Disease and OFF Periods
Authors
Rajesh Pahwa
Fernando L. Pagan
Daniel E. Kremens
Marie Saint-Hilaire
Publication date
23-05-2023
Publisher
Springer Healthcare
Published in
Neurology and Therapy / Issue 4/2023
Print ISSN: 2193-8253
Electronic ISSN: 2193-6536
DOI
https://doi.org/10.1007/s40120-023-00486-5

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