Efficacy of istradefylline for gait disorders with freezing of gait in Parkinson's disease: A single-arm, open-label, prospective, multicenter study.

Abstract

Background: Gait disorders are common in Parkinson's disease patients who respond poorly to dopaminergic treatment. Blockade of adenosine A2A receptors is expected to improve gait disorders. Istradefylline is a first-in-class selective adenosine A2A receptor antagonist with benefits for motor complications associated with Parkinson's disease. Research design and methods: This multicenter, open-label, single-group, prospective interventional study evaluated changes in total gait-related scores of the Part II/III Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Freezing of Gait Questionnaire (FOG-Q) in 31 Parkinson's disease patients treated with istradefylline. Gait analysis by portable gait rhythmogram was performed. Results: MDS-UPDRS Part III gait-related total scores significantly decreased at Weeks 4-12 from baseline with significant improvements in gait, freezing of gait, and postural stability. Significant decreases in MDS-UPDRS Part II total scores and individual item scores at Week 12 indicated improved daily living activities. At Week 12, there were significant improvements in FOG-Q, new FOG-Q, and overall movement per 48 h measured by portable gait rhythmogram. Adverse events occurred in 7/31 patients. Conclusions: Istradefylline improved gait disorders in Parkinson's disease patients complicated with freezing of gait, improving their quality of life. No unexpected adverse drug reactions were identified. Trial registration: UMIN-CTR (UMIN000020288).

• Authors: Mutsumi Iijima, Satoshi Orimo, Hiroo Terashi, Masahiko Suzuki, Akito Hayashi, Hideki Shimura, Hiroshi Mitoma, Kazuo Kitagawa, Yasuyuki Okuma
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 20 Issue 11 Pg. 1405-1411 (Aug 2019) ISSN: 1744-7666 [Electronic] England
• PMID: 31039621 (Publication Type: Clinical Trial, Phase I, Journal Article, Multicenter Study)

Chemical References

• Adenosine A2 Receptor Antagonists
• Purines
• istradefylline

Topics

• Adenosine A2 Receptor Antagonists (adverse effects, therapeutic use)
• Administration, Oral
• Aged
• Drug Administration Schedule
• Dyskinesias (etiology)
• Female
• Gait (physiology)
• Gait Disorders, Neurologic (complications, drug therapy)
• Humans
• Male
• Middle Aged
• Parkinson Disease (complications, drug therapy)
• Prospective Studies
• Purines (adverse effects, therapeutic use)
• Quality of Life
• Treatment Outcome