MDS 2023 | Should on-demand treatments for Parkinson’s disease OFF episodes be used earlier?

Most patients with Parkinson’s disease (PD) receiving levodopa develop motor fluctuations with an increasing amount of OFF time. Stuart Isaacson, MD, Director of the Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, discusses the importance of time to ON versus wearing OFF in total daily OFF time experienced by patients with PD. The delay in delivering oral levodopa to the intestine can lead to delayed onset of benefit, causing issues for patients. Dr Isaacson suggests a paradigm shift, emphasizing the need to focus on time to ON rather than just end-of-dose wearing off, and emphasizes the importance of empowering patients by discussing on-demand therapies as early treatment options, allowing them to have control over their symptoms. Recently, experts reached an agreement at a consensus meeting, which recommends considering on-demand therapies earlier when OFF episodes impact daily activities. This interview took place at the 2023 International Congress of Parkinson’s Disease and Movement Disorders in Copenhagen, Denmark.

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