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Optimizing levodopa therapy, when and how? Perspectives on the importance of delivery and the potential for an early combination approach

dc.contributor.authorLees, Andrew
dc.contributor.authorTolosa, Eduardo
dc.contributor.authorStocchi, Fabrizio
dc.contributor.authorFerreira, Joaquim J
dc.contributor.authorRascol, Olivier
dc.contributor.authorAntonini, Angelo
dc.contributor.authorPoewe, Werner
dc.date.accessioned2023-02-14T15:47:47Z
dc.date.available2023-02-14T15:47:47Z
dc.date.issued2023
dc.description© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.pt_PT
dc.description.abstractIntroduction: There is currently a resurgence of levodopa as the initial treatment of choice for most patients with Parkinson's disease, albeit at lower doses than previously used. The addition of adjuvant treatments (including MAO-B inhibitors, COMT inhibitors and dopamine agonists) is an established strategy to reduce motor complications that develop with sustained levodopa therapy. Areas covered: In this narrative review, the authors discuss the evidence underpinning current levodopa optimization strategies, during early disease and once motor complications occur. To support the discussion, the authors performed a broad PubMed search with the terms 'levodopa/L-dopa/L-Dopa, and Parkinson's disease,' restricted to clinical trials. There is now a wealth of evidence that improving levodopa delivery to the brain improves outcomes and we discuss how agents can be combined earlier in the course of disease to leverage the full potential of this strategy. Expert opinion: Levodopa remains the cornerstone of antiparkinsonian therapy. Several promising advances in formulation have been made and include novel extended-release oral drugs as well as non-oral delivery systems. However, evidence has long suggested that anti-parkinsonian medications may be better used in combination earlier in the disease, and consequently patients will benefit from low doses of several agents rather than ever larger levodopa doses.pt_PT
dc.description.sponsorshipThis paper was supported by BIAL, who procured medical writing support but had no other influence on the content of the paper. No author received any remuneration for the preparation of this article.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationExpert Rev Neurother. 2023 Feb 10;1-10pt_PT
dc.identifier.doi10.1080/14737175.2023.2176220pt_PT
dc.identifier.eissn1744-8360
dc.identifier.issn1473-7175
dc.identifier.urihttp://hdl.handle.net/10451/56313
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherTaylor & Francispt_PT
dc.relation.publisherversionhttps://www.tandfonline.com/journals/iern20pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectAdjunct therapypt_PT
dc.subjectCOMT inhibitorspt_PT
dc.subjectMAO-B inhibitorspt_PT
dc.subjectDeliverypt_PT
dc.subjectDopamine agonistspt_PT
dc.subjectLevodopapt_PT
dc.subjectParkinson’s diseasept_PT
dc.titleOptimizing levodopa therapy, when and how? Perspectives on the importance of delivery and the potential for an early combination approachpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage10pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleExpert Review of Neurotherapeuticspt_PT
person.familyNameFerreira
person.givenNameJoaquim J
person.identifier1624753
person.identifier.ciencia-id7D15-5CD6-6159
person.identifier.orcid0000-0003-3950-5113
person.identifier.scopus-author-id7403252466
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication54d84fe7-2cbd-4ddc-bce2-0ff2bd7c4cc9
relation.isAuthorOfPublication.latestForDiscovery54d84fe7-2cbd-4ddc-bce2-0ff2bd7c4cc9

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