Lessening Dyskinesia With Duodopa Linked to Better Quality of Life
By lessening the involuntary movements, called dyskinesia, experienced by people with advanced Parkinson’s disease, treatment with AbbVie’s Duodopa (levodopa-carbidopa intestinal gel) was linked with better health-related quality of life, according to a post-hoc analysis of a clinical trial.
Duodopa treatment also was tied to other added benefits, namely easing of pain, the analysis found, citing “long-term, real-world data.”
These results were reported in a poster titled “Dyskinesia, Pain, and Quality of Life in Parkinson’s Disease: Post Hoc Analysis From the DYSCOVER Study.” The poster was presented at the recent International Parkinson and Movement Disorder Society (MDS) Virtual Congress 2021.
“Our research presented at MDS 2021 builds upon our expertise in neuroscience and reinforces our mission to advance the standards of care for people living with … debilitating diseases,” Sebastian Sorsaburu, MD, vice president, global specialty care medical affairs at AbbVie, said in a press release.
“At AbbVie, we are committed to addressing the unmet needs of people living with a wide range of movement disorders,” Sorsaburu added.
Parkinson’s disease is characterized by the loss of neurons that make the neurotransmitter dopamine. Treatment with levodopa — a precursor to dopamine — has long been one of the mainstays for Parkinson’s patients. However, this medicine can lead to uncontrollable movements, a condition called levodopa-induced dyskinesia.
Carbidopa helps prevent the breakdown of levodopa, so more of it is available to the brain to make dopamine. This reduces the amount of levodopa that needs to be administered, easing side effects such as nausea and vomiting.
AbbVie’s Duodopa — called Duopa in the U.S. — is a combination of levodopa and carbidopa given over 16 hours via a tube that is surgically inserted into the intestines of people with advanced Parkinson’s who are experiencing dyskinesia.
The therapy was first approved across Europe in 2005, with regulatory approval following in the U.S. in 2015.
However, the impact of dyskinesia and how it correlates with other measures, such as health-related quality of life (HRQoL), activities of daily living (ADL), and pain, in patients with advanced Parkinson’s disease remains poorly described.
To learn more, researchers conducted a post-hoc analysis — a statistical analysis specified after the data were seen — of patients enrolled in the DYSCOVER Phase 3 study (NCT02799381) that assessed the effectiveness of Duodopa in lessening dyskinesia versus an optimized medical treatment.
Participants, still responsive to levopoda, were randomly assigned to either Duodopa or the optimized medical treatment for 12 weeks, or about three months.
The post-hoc analysis combined data from both groups, with a total of 60 patients. The researchers examined correlations between dyskinesia, HRQoL, ADL, and pain at the start of the trial (baseline) and then at the end of the 12 weeks.
Involuntary movements were measured using the unified dyskinesia rating scale (UDysRS) score system, while ADL was assessed using the unified Parkinson’s disease rating scale part II. Each item in the UDysRS is rated on a 0–4 scale, with higher scores meaning more severe impact.
Quality of life was assessed using the Parkinson’s disease questionnaire 8 (PDQ-8), and pain using the King’s Parkinson’s disease pain scale (KPPS). PDQ-8 is a measure of health-related quality of life in which higher scores indicate poorer quality, and KPPS is a specific rating scale to evaluate the burden of pain in the context of Parkinson’s.
At the study’s start, significant but moderate correlations were seen between dyskinesia and all the other three measures — HRQoL, ADL, and pain.
At the end of the 12-week treatment, these correlations became significantly stronger, with easing of dyskinesia strongly correlating with lessening in pain, as well as with ADL and pain, and HRQoL and pain.
Moderate correlations were seen between improvements in dyskinesia and HRQoL, and dyskinesia and ADL.
Overall, the findings suggest that easing of “dyskinesia may be associated with improvements in pain, ADL, and HRQoL,” the team concluded.