Would levodopa perform better if it was absorbed continously in your intestine? That is what a group of doctors wanted to know back in the 1980s when they first tried an experiment to introduce levodopa and carbidopa into the upper intestine of a small group of people with Parkinson's. The patients undergoing continuous levodopa therapy experienced a "heightened therapeutic effect, including a reduction in motor fluctuations."
Twenty-one years later, the medication called duodopa, administered into an area of the small intestine called the duodenum, is still in clinical trial in the United States. Using a small patient-controlled pump, the drug is continuously delivered through a tube that ends in the upper small intestine where it is rapidly absorbed. Some patients use a tube that travels through the nose, throat, and stomach, while others have the tube inserted surgically through the abdomenal wall. Patients load the pump with a gel that contains levodopa and carbidopa. This delivery system ensures a more even supply and uptake compared with the conventional tablet treatment.
Duodopa administered as continuous levodopa therapy has shown remarkable results in people with advanced Parkinson's disease. Among the most optimistic reports, some people who were previously bedridden were able to walk again and use ability they had lost.
Hopefully this therapy makes its way through clinical trials quickly for people in the United States. It appears to have considerable potential to help people with Parkinson's disease.
Sources:
We Move
Annals of Neurology, August 1986
