EAN 2026 | Current limits of L-DOPA therapy in PD and approaches to optimization
Francesca Morgante, MD, PhD, St George’s University of London, London, United Kingdom, discusses the current limits of levodopa (L-DOPA) therapy and emerging approaches to optimize this strategy. Prof. Morgante highlights that changes in the response to L-Dopa across the disease course, as well as gastrointestinal disturbances, are the key limitations. This interview took place at the 12th Congress of the European Academy of Neurology (EAN) in Geneva, Switzerland.
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Transcript
The current limit of levodopa therapy is linked to two main factors. The first one is disease progression. So the response to levodopa changes over disease progression with a shorter duration of the benefit of this medication. And this is determined by the progression of a presynaptic degeneration of dopaminergic neurons in the brain. There is another very important factor that is the gastrointestinal disturbances in Parkinson’s disease...
The current limit of levodopa therapy is linked to two main factors. The first one is disease progression. So the response to levodopa changes over disease progression with a shorter duration of the benefit of this medication. And this is determined by the progression of a presynaptic degeneration of dopaminergic neurons in the brain. There is another very important factor that is the gastrointestinal disturbances in Parkinson’s disease. So levodopa reaches the stomach and its absorption is linked to gastric emptying and all factors that affect gastric emptying and delay gastric emptying affect levodopa absorption and this leads to episodes of dose failure in the afternoon or delayed onset with a later onset of levodopa benefit so every intervention that overcomes the limitation of gastric emptying delay and absorption in the intestinal system might provide a better benefit in people with Parkinson’s disease who need dopaminergic treatment.
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