Continuous Infusion Therapy for Advanced Parkinson’s Disease

What is continuous infusion therapy for advanced Parkinson’s disease?

Continuous infusion therapy is a state-of-the-art treatment for adults with advanced Parkinson’s disease. The treatment offers continuous delivery of two levodopa-based medications (foscarbidopa and foslevodopa), which helps to manage the symptoms of Parkinson’s disease and improve quality of life of those affected. The medication is called Vyalev or Produodopa.

Subcutaneous infusion therapy involves the continuous administration of medication through a small pump connected to a thin, flexible tube placed under the skin. A steady delivery of medication is delivered to the patient, which helps to stabilize the symptoms of Parkinson’s disease, particularly when oral medications are no longer providing consistent symptom control.

Cleveland Clinic Abu Dhabi’s Parkinson’s Disease & Research Center is the first center in the region to offer continuous infusion therapy for advanced Parkinson’s disease.

How does continuous infusion therapy for advanced Parkinson’s disease work?

Continuous, subcutaneous infusion therapy works by delivering medication directly into the subcutaneous tissue (the innermost layer of the skin). This allows for rapid absorption of the medication into the bloodstream. Unlike oral medications, which can be affected by digestive processes, subcutaneous infusion provides a steady and predictable release of the drug. This helps reduce fluctuations in medication levels, often referred to as ‘on-off’ periods, which are common in advanced Parkinson’s disease.

Who is continuous infusion therapy for advanced Parkinson’s disease suitable for?

Continuous infusion therapy is recommended for people with advanced Parkinson’s disease who experience significant motor fluctuations despite optimized oral treatment. It may be suitable for people with advances Parkinson’s who:

• Have on/off periods that disrupt daily life.
• Respond well to levodopa or similar medications but require more stable delivery.
• Are unable to tolerate oral medications due to side effects or gastrointestinal issues.

A comprehensive evaluation by a neurologist or movement disorder specialist is essential to determine if continuous subcutaneous infusion therapy is appropriate.

How is continuous infusion therapy for advanced Parkinson’s disease given?

Continuous, subcutaneous infusion therapy is administered using a small portable pump. The process involves:

• Placement of the cannula: A thin, flexible tube (the cannula) is inserted under the skin, usually in the abdominal area or upper thigh.
• Programming the pump: The portable pump is programmed to deliver the medication at a consistent rate throughout the day. Adjustments may be made based on individual needs.
• Daily use: The pump is typically worn day and night and can be temporarily removed for any activity in which other liquids may come into contact with the pump.

What are the benefits of continuous infusion therapy for advanced Parkinson’s disease?

Continuous, subcutaneous infusion therapy offers several potential benefits for individuals with advanced Parkinson’s disease, including:

• Reduced fluctuations in symptoms: The therapy provides consistent symptom control by avoiding the peaks and troughs associated with oral medications.
• Improved quality of life: The therapy can help individuals maintain greater independence and engage in daily activities with fewer interruptions from symptoms.
• Ease of use: The portable pump system is discreet and allows for mobility during treatment.
• Convenience: The therapy reduces the reliance on frequent oral medications.
• Customizable treatment: Infusion rates can be adjusted to meet individual needs.

What are the disadvantages of continuous infusion therapy for advanced Parkinson’s disease?

While continuous, subcutaneous infusion therapy can be highly effective, it may not be suitable for everyone. Potential limitations and side effects include:

• Skin reactions: Irritation or redness at the infusion site is common but can usually be managed with proper care.
• Device management: Using the pump requires some training and daily attention to ensure proper functioning.
• Side effects of medication: The medication delivered through infusion may cause nausea, dizziness, or low blood pressure in some individuals.

It is important to note that while continuous infusion therapy for advanced Parkinson’s disease is effective in managing symptoms, the therapy does not halt the progression of Parkinson’s disease.

If you or a loved one are living with advanced Parkinson’s disease, talk to your neurologist to determine whether this innovative therapy could be right for you.