Date of Award
Spring 2020
Degree Name
Other
Master of Public Health, Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Erin Wolf B.S.N., M.S., PA-C
Abstract
Introduction: Though levodopa-carbidopa therapy remains the gold standard of Parkinson’s disease (PD) treatment to this day, patients often experience increased dyskinetic activity as a result of long-term treatment; known as levodopa-induced dyskinesia (LID); the mechanism of which is not completely understood. In this review, the efficacy of two adjunct treatments for LID are compared: 1) the concomitant administration of amantadine, an antiviral medication with antidyskinetic properties; and 2) a new form of levodopa administration in the form of an intestinal gel delivered straight via a device much like an insulin pump.
Methods: Two systematic literature searches of primary, peer-reviewed articles were performed during November 2018 utilizing both EBSCO-host and PubMed. Seven articles were identified as meeting literature review inclusion criteria; four related to LCIG and three related to amantadine therapy.
Results: After comprehensive analysis of study design, validity, and both clinical and statistical significance, it is the conclusion of this review that amantadine is the treatment modality with the greatest support in treating LID.
Discussion: As compared with those studies assessing the efficacy of LCIG, those looking at amantadine were more rigorous, were less subject to various bias, and were the most generalizable to a wider population.
Conclusion: At this time, recommendations for future research include additional, better designed studies of LCIG efficacy as well as more long-term, prospective studies assessing if and how the effectiveness of both treatment modalities changes over duration of treatment. This will give greater insight as to how beginning these treatments might affect patients’ disease course overall.
Recommended Citation
Timony, Katelynn, "The comparative efficacy of amantadine vs. LCIG therapy for the treatment of levodopa-induced dyskinesia in patients with advanced Parkinson's disease" (2020). Capstone Showcase. 28.
https://scholarworks.arcadia.edu/showcase/2020/pa/28
Included in
Nervous System Diseases Commons, Neurology Commons, Neurosciences Commons, Pharmaceutical Preparations Commons, Therapeutics Commons
The comparative efficacy of amantadine vs. LCIG therapy for the treatment of levodopa-induced dyskinesia in patients with advanced Parkinson's disease
Introduction: Though levodopa-carbidopa therapy remains the gold standard of Parkinson’s disease (PD) treatment to this day, patients often experience increased dyskinetic activity as a result of long-term treatment; known as levodopa-induced dyskinesia (LID); the mechanism of which is not completely understood. In this review, the efficacy of two adjunct treatments for LID are compared: 1) the concomitant administration of amantadine, an antiviral medication with antidyskinetic properties; and 2) a new form of levodopa administration in the form of an intestinal gel delivered straight via a device much like an insulin pump.
Methods: Two systematic literature searches of primary, peer-reviewed articles were performed during November 2018 utilizing both EBSCO-host and PubMed. Seven articles were identified as meeting literature review inclusion criteria; four related to LCIG and three related to amantadine therapy.
Results: After comprehensive analysis of study design, validity, and both clinical and statistical significance, it is the conclusion of this review that amantadine is the treatment modality with the greatest support in treating LID.
Discussion: As compared with those studies assessing the efficacy of LCIG, those looking at amantadine were more rigorous, were less subject to various bias, and were the most generalizable to a wider population.
Conclusion: At this time, recommendations for future research include additional, better designed studies of LCIG efficacy as well as more long-term, prospective studies assessing if and how the effectiveness of both treatment modalities changes over duration of treatment. This will give greater insight as to how beginning these treatments might affect patients’ disease course overall.