Long-term use of
levodopa (
L-dopa) in patients with
Parkinson's disease is associated with development of
dyskinesia. This study explored whether
Parkinson's disease patients with
L-dopa-induced
dyskinesia experience improved OFF-time from higher
L-dopa doses without worsening of
dyskinesias when receiving adjunctive
mavoglurant. Patients with moderate-to-severe
L-dopa-induced
dyskinesia were randomized to receive
mavoglurant or placebo.
Mavoglurant (
AFQ056) was up-titrated over two weeks from 25 mg twice daily (bid) to 100 mg bid (
L-dopa kept stable), followed by three weeks during which the daily
L-dopa dosage was increased by up to 300 mg/day. A sample size of 30 was initially planned; however, the study was terminated prematurely due to enrollment challenges. OFF-time showed greater improvements in the
mavoglurant group (n = 7) compared with the placebo group (n = 7); difference at week 5 was -2.77 h (90% confidence interval -5.44, -0.09 h; p = 0.09). ON-time without troublesome
dyskinesia increased more from baseline to week 5 in the
mavoglurant group (4.38 h) versus the placebo group (0.63 h). Clinician-rated measures were conflicting. The Modified Abnormal
Involuntary Movement Scale scores showed a slight improvement with
mavoglurant compared with placebo, while the Unified
Dyskinesia Rating Scale parts III and IV worsened slightly with
mavoglurant compared with placebo. Due to the low patient numbers and conflicting clinician-rated outcomes data, our findings are not conclusive. However, our results suggest that
mavoglurant combined with higher doses of
L-dopa may be effective in treating patients with
Parkinson's disease experiencing
L-dopa-related motor fluctuations and
dyskinesias.