Continuous L-DOPA Delivery

Numerous small studies demonstrate that IV infusion of L-DOPA stabilizes its concentration in plasma, eliminates most motor fluctuations, and enables people with PD to go off most of their other PD medications.1  Larger studies show similar outcomes using continuous L-DOPA infusion directly into the duodenum using an ambulatory infusion pump (Duopa therapy).2  For example, a large Duopa study demonstrated reductions in time spent in the "off" state and time spent with severe dyskinesias of over 65%, as well as significant increases in quality of life for people with PD.

Despite the superior efficacy of continuous L-DOPA delivery, the therapies tested to date are inappropriate or impractical for widespread adoption. IV infusion is not suitable for long-term use by ambulatory patients outside the hospital due to infection risk. Duopa therapy requires surgical implantation of a tube from an external infusion pump through the abdomen and into the duodenum. It also has a high rate of complications, notably infection and migration of the tube out of the duodenum.

A practical, patient-friendly, non-invasive and continuous infusion therapy for achieving stable L-DOPA levels in the body is required.

1) Shoulson, Neurology, 1975; Rosin, Arch Neurol, 1979; Quinn, The Lancet, 1982; Quinn, Neurology, 1984; Nutt, NEJM, 1984; Hardie, Br. J. clin Pharmac, 1986; Nutt, Mov Disord, 1997

2) Olanow, The Lancet, 2013; Slevin, Journal of Parkinson’s Disease, 2015; Fernandez, Movement Disorders, 2015.