EAN 2025 | Personalizing Parkinson’s treatment: the right therapy for the right patient at the right time
Angelo Antonini, MD, PhD, University of Padua, Padua, Italy, gives guidance to clinicians treating patients with Parkinson’s disease on choosing the right therapy for the right patient at the right time. He highlights two critical moments: diagnosis and disease progression. He stresses the need to discuss all treatment options with patients, including advanced therapies, to prevent worsening of their clinical state. This interview took place at the 11th Congress of the European Academy of Neurology (EAN 2025) in Helsinki, Finland.
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Transcript
This is a challenge. After so many years of dealing with Parkinson’s, still we face challenges in defining what is the right patient and what is the right time to introduce it. I think there are two moments that are pretty critical in Parkinson’s. One is the diagnosis. At the beginning of the disease, we need to choose the treatment that provides the most benefit and in general I think this is these days as levodopa associated maybe with monoamine oxidase inhibitors and later maybe agonists...
This is a challenge. After so many years of dealing with Parkinson’s, still we face challenges in defining what is the right patient and what is the right time to introduce it. I think there are two moments that are pretty critical in Parkinson’s. One is the diagnosis. At the beginning of the disease, we need to choose the treatment that provides the most benefit and in general I think this is these days as levodopa associated maybe with monoamine oxidase inhibitors and later maybe agonists. And then when the disease progresses and people with Parkinson’s start experiencing fluctuations in the clinical state, I think we have other drugs like COMT inhibitors but also we need to discuss about advanced treatments, infusions, deep brain stimulation, focused ultrasound, maybe an option in selected cases. I think what is very important is to discuss this with patients, present them all options, don’t let them go with their ongoing treatment worsening in their clinical state. I think that people with Parkinson’s do deserve to be informed about existing options in the treatment. I think that we have been developing tools and systems to present the patients and also to introduce this concept of advanced treatments to the clinicians. I’ve been personally involved in a tool which is called Manage PD tool but also in a very simple algorithm, which is 5 to 1, which if you increase the number of levodopa intakes up to five times, or if your patient has about two hours of disability during the day, I think this is a good time to discuss a treatment change and to introduce the concept about devised therapies.
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