Asian perspectives on the recognition and management of levodopa 'wearing-off' in Parkinson's disease

Bhidayasiri R 1 , Hattori N 2 , Jeon B 3 , Chen RS 4 , Lee MK 5 , Bajwa JA 6 Show all authors , Mok VC 7 , Zhang B 8 , Syamsudin T 9 , Tan LC 10 , Jamora RD 11 , Pisarnpong A 12 , Poewe W 13

Affiliations 

  • 1 a 1 Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
  • 2 b 2 Juntendo University School of Medicine, Tokyo, Japan
  • 3 c 3 Seoul National University, Seoul, South Korea
  • 4 d 4 Chang Gung Memorial Hospital, Lingkou, Taiwan
  • 5 e 5 Sunway Medical Centre, Jalan Lagoon Selatan, Bandar Sunway, 46150 Petaling Jaya, Selangor, Malaysia
  • 6 f 6 National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
  • 7 g 7 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
  • 8 h 8 Department of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • 9 i 9 National Brain Centre Hospital, Jakarta, Indonesia
  • 10 j 10 National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore
  • 11 k 11 Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
  • 12 m 13 Department of Neurology, Bangkok Hospital, Bangkok, Thailand
  • 13 n 14 Innsbruck Medical University, Innsbruck, Austria
Expert Rev Neurother, 2015;15(11):1285-97.
PMID: 26390066 DOI: 10.1586/14737175.2015.1088783

Abstract

Most Parkinson's disease patients will receive levodopa therapy, and of these, the majority will develop some levodopa-induced complications. For many patients, the first complication to develop is the decline in the duration of therapeutic benefit of each levodopa dose, a phenomenon commonly termed 'wearing-off'. There is already extensive literature documenting the epidemiology and management of wearing-off in Parkinson's disease patients of western descent. However, data derived from these studies might not always apply to patients of Asian descent due to genetic variations, differences in co-morbidities or non-availability of certain drugs. This review summarizes the current literature regarding the epidemiology of wearing-off in Asian (including Arab) patients and discusses the management issues in the context of drug availability in Asia.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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