December 5, 2025

@michaelokun

Do younger folks accumulate more stable days w/ continuous foslevodopa/foscarbidopa? Spoiler alert: YES. This product is a ‘prodrug.’ A prodrug means a medication that is delivered in an 'inactive form' and then is converted by the body into its active drug. Angelo Antonini and colleagues describe in a new paper in Neurology and Therapy that younger folks ‘earlier’ in their advanced Parkinson’s journey, may experience greater motor and sleep benefits w/ continuous subcutaneous foslevodopa/foscarbidopa when compared w/ standard oral levodopa/carbidopa. Key Points: - Younger patients had larger improvements in reducing ‘off’ time and increasing good ‘on’ time compared w/ oral levodopa/carbidopa. - Sleep scores improved significantly in the infusion group, while the oral group showed minimal change. - Quality of life trends were stronger w/ infusion therapy. - Safety findings remained consistent w/ the overall population. My take: When we think about subcutaneous pumps, should we be thinking earlier and younger? Here are 5 points that resonated w/ me about this article. 1- Continuous delivery can smooth the day by reducing the peaks and valleys that come w/ using Parkinson pills. 2- Implanting younger folks earlier in advanced PD may respond more robustly, possibly because more dopamine pathways remain intact. 3- Sleep frequently improves when motor fluctuations are better controlled. 4- Infusion site issues are expected, however they are usually mild and manageable when teams provide proper support. 5- Earlier consideration of device-aided therapy may help preserve function, especially when oral medications no longer provide stable control. https://link.springer.com/article/10.1007/s40120-025-00856-1 #parkinson #fixelinstitute #michaelokun