Duodopa (levodopa/carbidopa intestinal gel) is for the treatment of advanced levodopa-responsive Parkinson’s disease with severe motor fluctuations and hyperkinesia or dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results1
People in this piece are models, not actual patients.
People in this piece are models, not actual patients.
Duodopa (levodopa/carbidopa intestinal gel) is for the treatment of advanced levodopa-responsive Parkinson’s disease with severe motor fluctuations and hyperkinesia or dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results1
People in this piece are models, not actual patients.
Because ON TIME is their time
Duodopa is a device-aided therapy for advanced Parkinson’s disease:
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Approximately 4 hours more ‘ON’ time each day – and 4 hours less ‘OFF’ time each day with Duodopa2 |
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Increased ‘ON’ time and decreased ‘OFF’ time with Duodopa sustained for more than 4 years3 |
See Duodopa dosing information
| * | PDQ-39 scale assessed several domains including mobility, activities of daily living, and communication. The PDQ-39 Summary Index showed a decrease from baseline of 10.9 points at week 121,2 |
See Duodopa dosing information
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Safety profile characterized over 17 years4 |
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Approved for use in 48 countries5 |
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The most common adverse reaction was complication of device insertion1 |
See Duodopa dosing information
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The Duodopa dose is composed of three individually adjusted doses providing continous dopaminergic stimulation for 16 hours.1 Treatment is usually administered during the patient's awake period. If medically justified, Duodopa may be administered for up to 24 hours1 |
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After initiation, fine adjustments of these three components of the overall dosage should be made over a few weeks to achieve an optimum dose1 |
See Duodopa dosing information
PATIENT PROFILES
Which of your patients would benefit from Duodopa?
Duodopa is used to treat patients with advanced levodopa-responsive Parkinson’s disease with severe motor fluctuations and hyperkinesia or dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results.
To ensure that patients receive Duodopa at the appropriate time, clinical criteria to define advanced Parkinson’s disease are required
- A consensus was developed with a panel of 17 movement disorder specialists from 10 countries and proposed 15 indicators of suspected advanced Parkinson’s disease6†
- The consensus group also proposed 7 indicators of when a person may be eligible for device-aided therapy, such as Duodopa6
- Among the 15 indicators, 3 were proposed among key clinical indicators of APD
| – | Taking at least 5 oral levodopa doses per day |
| – | Having at least 2 hours of ‘OFF’ time per waking day |
| – | Having at least 1 hour of troublesome dyskinesia per waking day |
The presence of at least one of these indicators may be a sign of advanced Parkinson’s disease
Is Duodopa right for your advanced Parkinson’s disease patients?
Click on the patient profiles to find out which patient may benefit from Duodopa
PETER
Active with persistent bradykinesia
MARIE
Moderately active with unpredictable freezing
GEORGE
Active with troublesome dyskinesia
Peter – active with increased bradykinesia*
| • | Aged 66 years |
| • | Aged 57 years at onset of Parkinson’s disease |
| • | Lives with partner and daughter |
| • | Taking oral levodopa for 6 years but with increasing dyskinesia |
| • | Peter loves his job as a landscape gardener |
Why prescribe Duodopa?
With more than 2 hours a day ‘OFF’ time, Peter’s increased bradykinesia has made him unable to accept new projects, which is affecting his quality of life
*This is a fictional patient but is based on insights from real patients
Marie – moderately active with unpredictable freezing*
| • | Aged 70 years |
| • | Aged 60 years at onset of Parkinson’s disease |
| • | Lives with husband |
| • | Taking oral levodopa for 8 years but with severe motor fluctuations |
| • | A retired journalist, Marie writes for pleasure but poor symptom control has restricted her ability |
Why prescribe Duodopa?
Marie is now taking oral levodopa more than 5 times a day but is still having ‘OFF’ time and unpredictable periods of freezing, both of which are significantly reducing her quality of life
*This is a fictional patient but is based on insights from real patients
George – active with troublesome dyskinesia*
| • | Aged 63 years |
| • | Aged 55 years at onset of Parkinson’s disease |
| • | Lives with wife and two sons |
| • | Taking oral levodopa for 8 years with troublesome dyskinesia |
| • | A highly regarded teacher, George is helping to fund his sons’ education as well as saving for retirement |
Why prescribe Duodopa?
He expressed concern that his oral medication doesn’t seem to be working.
*This is a fictional patient but is based on insights from real patients
Download the Duodopa snapshot brochure
IMPORTANT SAFETY INFORMATION1
Duodopa is contraindicated in patients with hypersensitivity to levodopa, carbidopa or any of the excipients, narrow-angle glaucoma, severe heart failure, severe cardiac arrhythmia, acute stroke, selective type A inhibitors and nonselective MAO inhibitors, conditions contraindicated for adrenergics (e.g. pheochromocytoma, hyperthyroidism, and Cushing’s syndrome), and suspicious skin lesions or history of melanoma.
Some warnings and precautions include the following: Device and Procedure-related complications, sudden onset of sleep: caution should be exercised when driving and operating machines. Caution in: severe cardiovascular or pulmonary disease, bronchial asthma, renal, hepatic or endocrine disease, or history of peptic ulcer disease or of convulsions. Risk of symptoms resembling Neuroleptic Malignant Syndrome following abrupt dose reduction or discontinuation. Monitor all patients for the development of mental changes, depression with suicidal tendencies, and other serious mental changes. Caution in chronic wide-angle glaucoma; monitor for intra-ocular pressure changes. Patients with past or current psychosis should be treated with caution. Monitor patients regularly for the development of impulse control disorders, for example Dopamine Dysregulation Syndrome (DDS). Polyneuropathy has been reported; evaluate for history/signs
of and known risk factors before starting therapy. Periodic evaluation of hepatic, haematopoietic, cardiovascular and renal function is recommended during extended therapy with Duodopa. Some reported complications include, but are not limited to, abscess, pneumonia (including aspiration pneumonia), and sepsis. Patients with Parkinson’s disease have a higher risk of developing melanoma. Monitor patients for melanomas on a regular basis when using Duodopa. Duodopa is not recommended during pregnancy. Breast-feeding should be discontinued during treatment with Duodopa. The most common adverse reaction was complication of device insertion.
The very common (≥ 10%) and common (≥1% to < 10%) device and procedure -related adverse reactions reported in the clinical trials included in clinical trials included: Abdominal discomfort, Abdominal pain, Peritonitis, Pneumoperitoneum Postoperative wound infection, incisional cellulitis, pneumonia/aspiration pneumonia, excessive granulation tissue, device dislocation, device occlusion, complications of device insertion, incision site erythema, post-procedural discharge, stoma complication, incision site pain, Postoperative Ileus, Post procedural complication, Post procedural discomfort, post procedural haemorrhage.
Most of these adverse reactions were reported early in the studies, subsequent to the percutaneous endoscopic gastrostomy procedure and occurred during the first 28 days.
Drug related undesirable effects that occur frequently with the Duodopa system include nausea and dyskinesia.
*The safety information provided is based on the Duodopa (levodopa/carbidopa intestinal gel) Summary of Product Characteristics (SmPC). Please refer to your country specific product labeling for complete product safety information
Please see Duodopa Summary of Product Characteristics for complete prescribing information
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References
- Duodopa (levodopa/carbidopa intestinal gel) SmPC.
- Olanow CW et al. Lancet Neurol 2014; 13(2):141-149.
- Fernandez HH et al. Mov Disord 2018; 33(6):928-936.
- https://www.ema.europa.eu/en/ medicines/human/orphan-designations/ eu301035. Accessed 24 November 2020.
- Antonini A et al. Curr Med Res Opin 2018; 34(12):2063-2073.
† This study and publication were funded by AbbVie.