How do you manage random-OFF periods in patients with Parkinson's disease who are otherwise having good control of their motor symptoms?

1 Answer

Mednet Member

Neurology · Northwestern University

Answered on

That's a great question.
This clinical scenario is perfect for the use of Parkinson's "rescue therapies." Rescue therapies are those that have a quick-onset of action to provide quick relief, without a significant duration of effect and limited side effects.

There are two relatively new drugs on the market that fall into this category:
1) Inbrija, which is an inhaler of levodopa inhalation powder, and
2) Kynmobi, which is a sublingual film of apomorphine.

Studies leading to the approval of these medications showed that they reverse off symptoms in ~10-15 minutes and last up to 60 minutes. Dyskinesia is a shared potential side effect for both medications. Inbrija cannot be used in those with restrictive lung disease. Kynmobi has to be titrated to find the sublingual dose that works for the patient, and given potential side effect of hypotension, can be done under clinical observation.