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Patch May Provide Steady Dose of Parkinson's Meds November 12, 2002 01:28 PM ET By Paula Moyer MIAMI (Reuters Health) - A patch that delivers the drug rotigotine through the skin may reduce the fluctuating symptoms that are the bane of many people with Parkinson's disease, according to Dr. Peter A. LeWitt, speaking here at the Movement Disorders Society's Seventh International Congress of Parkinson's Disease and Movement Disorders. "Patients who live with Parkinson's disease want a continuous effect from their medication, and physicians want it for them," LeWitt told Reuters Health. "Current therapies don't provide this, and the pulsatile effect that they live with now is responsible for the fluctuations in their symptoms." Because patients with Parkinson's disease take several daily doses of the mainstay medication levodopa, the effects of this medication are seen in intermittent, or pulsatile, bursts, said LeWitt, a professor of neurology at Wayne State University in Detroit and the director of the Clinical Neuroscience Center in Southfield, Michigan. He said that studies on the rotigotine patch were designed to see if it would achieve continuous dosing and bring patients greater symptom relief. Rotigotine belongs to a class of drugs called dopamine agonists, which are used in the treatment of Parkinson's disease to enhance the effect of levodopa. They can also be used alone. The challenge has been to find a dopamine agonist that can be absorbed throughout the body through a transdermal patch--a drug delivery system that is worn on the skin, typically the forearm, and releases a drug continuously, said LeWitt. Previous research has shown that the drug rotigotine reverses parkinsonian symptoms in animals with induced motor impairments. LeWitt and colleagues think that continuous delivery of the drug could address several issues in the management of Parkinson's disease that are neglected by current treatment, primarily a shortened response time after taking medication and less "off" time, or time when the medication is not working. For example, the patch could be an alternative for multiple daily oral doses of medication, and it may be more tolerable for patients who have adverse reactions--such as involuntary movements and hallucinations--with dopamine agonist medication when the drug reaches its peak effect. Because patients with Parkinson's disease can experience slowed digestion, taking drugs orally can be less effective because of problems with absorption in the stomach and other parts of the gastrointestinal tract. Transdermal delivery avoids this problem. Earlier clinical trials indicated that rotigotine has the potential to address these issues, LeWitt said. One study involving 383 patients showed a reduced "off" time, with patients returning to their pre-rotigotine-treatment "off" times when the patch was removed. Another study involved 329 patients and focused on reduction of involuntary movements. In that study the investigators found that the patch avoided peak-effect problems. "The transdermal patch has been tested in both newly diagnosed Parkinson's disease patients and those with advanced disease who have fluctuating symptoms," he told Reuters Health. "Recent trials show that it's associated with improved symptomatic relief and increases the 'on' time. These findings are consistent with earlier studies. I'm participating in ongoing investigations regarding rotigotine's safety and efficacy and identifying the right doses." A key goal of those investigations is determining the drug's potential for reducing the involuntary movements that are caused by pulsatile dosing. Investigators also want to know if rotigotine can slow progression of Parkinson's disease, said LeWitt. Other dopamine agonists, including pergolide, pramipexole and ropinirole, seem to have this potential, he said. Research on rotigotine has been sponsored by Schwarz Pharma, the drug's manufacturer. SOURCE: Reuters UK http://reuters.com/news_article.jhtml?type=healthnews&StoryID=1723619 * * * ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn