This promotional material is intended for UK Healthcare Professionals (HCPs) experienced in the diagnosis and management of Parkinson’s disease only. Adverse event reporting can be found below
DUODOPA (levodopa/carbidopa intestinal gel)
DUODOPA
(levodopa/carbidopa intestinal gel)
PRODUODOPA (foslevodopa/foscarbidopa solution for infusion)
PRODUODOPA
(foslevodopa/foscarbidopa solution for infusion)
A look at Complex/Advanced Parkinson's disease
DUODOPA (levodopa/carbidopa intestinal gel) is indicated 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 results.1
PRODUODOPA (foslevodopa/foscarbidopa solution for infusion) is indicated 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 results.2,3
Levodopa may activate malignant melanoma, so PRODUODOPA and DUODOPA should not be used in patients with suspicious undiagnosed skin lesions or a history of melanoma.1-3
Approximately 1 in 3 patients with PD have Complex/Advanced disease (n=3,515/10,335)4
But a treatment gap remains
patients with Complex/Advanced PD receive non-oral therapies (n=4,200/49,300)4-6*
*Calculated using 2020 Hospital Pharmacy Audit data (purchased from IQVIA) and total 2020 PD prevalence data using Parkinson’s UK report (as referenced).Prevalence of complex Parkinson’s disease applied from the 2019 Parkinson’s UK report (as referenced).
The 5-2-1 criteria could help you identify patients with PD who may be progressing into the Complex/Advanced stage and may be eligible for non-oral therapies. Look out for the following signs:7
≥ 5 times per day when oral levodopa is taken
≥ 2 hours per day of ‘OFF’ time
≥ 1 hour per day with troublesome dyskinesia
≥ 5 times per day when oral levodopa is taken
≥ 2 hours per day of ‘OFF’ time
≥ 1 hour per day with troublesome dyskinesia
The '5 or 2 or 1' criteria may be adopted as a simple screening tool for assessing symptom control7,11
A Delphi-panel approach was utilised to synthesise opinions from movement disorder specialists and build a consensus on markers for the progression to Complex/Advanced Parkinson's disease (PD). They identified 3 criteria as key indicators of transition to Complex/Advanced PD:7,11*
A threshold for the next step
Just ONE of these suggests possible Complex/Advanced PD:
- 5 or more times per day when oral levodopa is taken
- 2 or more hours of 'OFF' time every day
- 1 or more hour of troublesome dyskinesia every day
A panel was comprised of 17 (with 15 completing all 3 rounds) leading movement disorder specialists from 10 European countries with extensive experience of treating Parkinson's disease patients (mean (SD) = 23.9 ± 6.4 years), between February 2014 and January 2015. Consensus on indicators of suspected Complex/Advanced PD and eligibility for non-oral therapies were based on motor symptoms, non-motor symptoms, and functional impairments. Based on clinical importance, panellists ranked the relative priority of the 15 consensus indicators of suspected Complex/Advanced PD within motor, non-motor, and functional impact domains. AbbVie co-authors were involved in this study.
Do you use the 5-2-1 criteria to assess when your patients with Complex/Advanced PD may be ready for non-oral therapy?
Explore some patient profiles to see how “5-2-1” could be used in practice
Stay connected
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Please only fill out your details if you are a UK registered healthcare professional.
1. DUODOPA (levodopa/carbidopa intestinal gel) SmPC.
2. PRODUODOPA (foslevodopa/foscarbidopa solution for infusion) GB SmPC.
3. PRODUODOPA (foslevodopa/foscarbidopa solution for infusion) NI SmPC.
4. Parkinson’s UK. 2019 Parkinson’s audit: Summary report. Available from: https://www.parkinsons.org.uk/professionals/. Accessed December 2023.
5. AbbVie. Data on File, HPA data for DAT patients, UK-DUOD-220019.
6. Parkinson’s UK. Reporting on Parkinson’s: Information for journalists. Available at: https://www.parkinsons.org.uk/. Accessed December 2023.
7. Antonini A, et al. Curr Med Res Opin. 2018; 34: 2063–73.
8. Mills J, Martin A. Br J Neurosci Nurs. 2015; 11(2): 92–7.
9. Worth PF. Pract Neurol 2013; 13: 140–52.
10. NICE. Parkinson’s disease in adults. Available at: www.nice.org.uk/guidance/ng71. Accessed December 2023.
11. Santos-Garcia D, et al. Parkinson's Dis. 2020: 7537924.
Adverse events should be reported. Reporting forms and information can be found at yellowcard.mhra.gov.uk or via the MHRA Yellow Card app, available in the Google Play or Apple App Stores.
Adverse events should also be reported to AbbVie on [email protected]
UK-PRODD-230067. Date of preparation: December 2023
