Novel levodopa formulations in the treatment of Parkinson's disease

Levodopa is the gold standard in Parkinson's disease (PD) treatment but its use is associated with motor complications. Levodopa pharmacokinetics, a short half-life, erratic gastric emptying and duodenal absorption, are key factors in their pathogenesis. As the disease progresses, frequency of levodopa administrations is increased leading to a complex treatment schedule and poor patient compliance. The development of long acting formulations ensuring continuous delivery is therefore crucial to improve daily motor control. Available controlled release levodopa formulations produce more sustained plasma levels but also show lower bioavailability and slower time to peak, resulting in poor clinical outcome especially in advanced patients. IPX066 is a newly developed experimental formulation with a more favorable plasma profile than immediate-release levodopa, resulting in improved motor control and reduced dose frequency, which may increase adherence. Novel delivery systems such as inhaled levodopa or transdermal levodopa micropumps are also currently being investigated for efficacy with promising future perspectives.