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CNS Neurosci Ther. 2018 May;24(5):439-447. doi: 10.1111/cns.12807. Epub 2018 Jan 25.

Individualization of levodopa treatment using a microtablet dispenser and ambulatory accelerometry.

Author information

1
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
2
RISE Acreo AB, Gothenburg, Sweden.
3
Department of Clinical Neuroscience, Neurology, Karolinska Institutet, Stockholm, Sweden.
4
Department of Information Technology, Uppsala University, Uppsala, Sweden.
5
Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
6
Sensidose AB, Sollentuna, Sweden.
7
Computer Engineering, Dalarna University, Falun, Sweden.
8
Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Abstract

AIM:

This 4-week open-label observational study describes the effect of introducing a microtablet dose dispenser and adjusting doses based on objective free-living motor symptom monitoring in individuals with Parkinson's disease (PD).

METHODS:

Twenty-eight outpatients with PD on stable levodopa treatment with dose intervals of ≤4 hour had their daytime doses of levodopa replaced with levodopa/carbidopa microtablets, 5/1.25 mg (LC-5) delivered from a dose dispenser device with programmable reminders. After 2 weeks, doses were adjusted based on ambulatory accelerometry and clinical monitoring.

RESULTS:

Twenty-four participants completed the study per protocol. The daily levodopa dose was increased by 15% (112 mg, P < 0.001) from period 1 to 2, and the dose interval was reduced by 12% (22 minutes, P = 0.003). The treatment adherence to LC-5 was high in both periods. The MDS-UPDRS parts II and III, disease-specific quality of life (PDQ-8), wearing-off symptoms (WOQ-19), and nonmotor symptoms (NMS Quest) improved after dose titration, but the generic quality-of-life measure EQ-5D-5L did not. Blinded expert evaluation of accelerometry results demonstrated improvement in 60% of subjects and worsening in 25%.

CONCLUSIONS:

The introduction of a levodopa microtablet dispenser and accelerometry aided dose adjustments improve PD symptoms and quality of life in the short term.

KEYWORDS:

Parkinson's disease; accelerometry; dose titration; microtablets; observational study

PMID:
29652438
DOI:
10.1111/cns.12807
[Indexed for MEDLINE]

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