Onset of Efficacy with Continuous, Subcutaneous Levodopa/carbidopa Infusion in Patients with Parkinson’s Disease Experiencing Motor Fluctuations
Aaron Ellenbogen1, Fabrizio Stocchi2, Nelson Lopes3
1Michigan Institute for Neurological Disorders, 2University San Raffaele Roma and Institute for Research and Medical Care IRCCS San Raffaele, 3NeuroDerm
Objective:

Evaluate the onset of efficacy for continuous 24-hour subcutaneous infusion of liquid levodopa/carbidopa (LD/CD) with investigational ND0612.

Background:

Primary results from this Phase 2 study (NCT02577523) demonstrated that 28 days of treatment with 24-hour ND0612 infusion increased ON-time with no/mild dyskinesia (Good ON) by 3.7 [1.9, 5.6] hours (p < 0.0001) in patients with PD experiencing motor fluctuations (Olanow et al., J Parkinsons Dis 2021;11:177-186). However, less is known about the onset of efficacy following subcutaneous LD/CD infusion.

Design/Methods:

We report data from a secondary analysis of patients treated with the 24-hour ND0612 infusion regimen (N=19). Patients received the infusion at a rate of 0.64 mL/hour from 4AM to 10PM and 0.08 mL/hour between 10PM and 4AM to a total LD/CD dose of 720/90 mg. Motor status was determined by a blinded-rater at 30-minute intervals for 8 hours. Patients also assessed the time to full ON each morning in a diary. The first post-baseline efficacy evaluations were performed at Day 3.

Results:

At Day 3, patients treated with 24-hour ND0612 infusion showed a significant increase from baseline in Good ON-time (+1.83 [0.30, 3.35] hours, p=0.02), and a significant reduction in ON-time with moderate-severe dyskinesia (-1.36 [-2.29, -0.42] hours, p=0.006). Improvements at Day 3 were also noticeable in the Subject and Clinician Global Impressions of change (SGI and CGI improvements were reported for 73.7% and 52.6% of patients, respectively). By the end of the first week of treatment, the proportion of patients who reported achieving a full ON at 9AM increased from 31.6% at baseline to 72.2%.

Conclusions:

Results of this analysis demonstrate that patients experience statistically significant and clinically relevant improvements with 24-hour subcutaneous infusion with ND0612 at Day 3 after treatment initiation that improved further to Day 28 (primary endpoint). 

10.1212/WNL.0000000000204743