Objective:

This post hoc analysis evaluated LDp/CDp efficacy by baseline duration of troublesome dyskinesia.

Background:

Troublesome dyskinesia, a complication from Parkinson’s disease (PD) progression and pulsatile dopaminergic stimulation, impairs daily living. Foslevodopa/foscarbidopa (LDp/CDp), a formulation of levodopa/carbidopa prodrugs delivered as a continuous (24‑hour/day) subcutaneous infusion, increased “On” time without troublesome dyskinesia in 2 phase 3 clinical trials. 

Design/Methods:

Patients with levodopa-responsive idiopathic PD aged >=30 years who were inadequately controlled by current therapy and had >=2.5 “Off” hours/day received LDp/CDp in a 52‑week, phase 3, open-label trial (NCT03781167). The change from baseline (CFB) to final visit was assessed for “On” time with troublesome dyskinesia (PD diary; normalized to 16-hour waking day), time spent with dyskinesias (Movement Disorder Society-Unified PD Rating Scale [MDS‑UPDRS] Part 4.1), functional impact of dyskinesias (MDS-UPDRS Part 4.2), and 39-item PD Questionnaire (PDQ-39) in patient subgroups with >0.5 and >1.0 hours of troublesome dyskinesia at baseline.

Results:

Baseline characteristics were similar across subgroups with >0.5 (n=83) and >1.0 hours (n=66) of troublesome dyskinesia at baseline; mean (SD) duration of troublesome dyskinesia was 2.7 (2.0) and 3.1 (2.0) hours, respectively. In both subgroups, LDp/CDp led to numerical or significant improvements from baseline in troublesome dyskinesia (mean [SD] CFB −1.4 [3.4] and −2.5 [2.2] hours, respectively; P<.05), time spent with dyskinesias (P<=.001), functional impact of dyskinesias (P<=.001), and PDQ-39 (P<.05 for >0.5 hour subgroup). 

Conclusions:

Continuous delivery of LDp/CDp was associated with significant improvements in dyskinesia and quality of life in patients with relevant/significant troublesome dyskinesia at baseline.