title: Asian perspectives on the recognition and management of levodopa 'wearing-off' in Parkinson's disease.
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.
authors.affiliation: 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.
authors.forename: Roongroj
authors.initials: R
authors.lastname: Bhidayasiri
authors.affiliation: b 2 Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.affiliation: c 3 Seoul National University, Seoul, South Korea.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Jeon
authors.affiliation: d 4 Chang Gung Memorial Hospital, Lingkou, Taiwan.
authors.forename: Rou-Shayn
authors.initials: RS
authors.lastname: Chen
authors.affiliation: e 5 Sunway Medical Centre, Jalan Lagoon Selatan, Bandar Sunway, 46150 Petaling Jaya, Selangor, Malaysia.
authors.forename: Moon Keen
authors.initials: MK
authors.lastname: Lee
authors.affiliation: f 6 National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Jawad A
authors.initials: JA
authors.lastname: Bajwa
authors.affiliation: g 7 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Vincent C T
authors.initials: VC
authors.lastname: Mok
authors.affiliation: h 8 Department of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Baorong
authors.initials: B
authors.lastname: Zhang
authors.affiliation: i 9 National Brain Centre Hospital, Jakarta, Indonesia.
authors.forename: Thamrin
authors.initials: T
authors.lastname: Syamsudin
authors.affiliation: j 10 National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore.
authors.forename: Louis Chew Seng
authors.initials: LC
authors.lastname: Tan
authors.affiliation: k 11 Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.|l 12 Movement Disorder Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center-Quezon City and Global City, Philippines.
authors.forename: Roland Dominic G
authors.initials: RD
authors.lastname: Jamora
authors.affiliation: m 13 Department of Neurology, Bangkok Hospital, Bangkok, Thailand.
authors.forename: Apichart
authors.initials: A
authors.lastname: Pisarnpong
authors.affiliation: n 14 Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
mesh_terms: D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D044466:Asian People; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis* / Q000208:ethnology*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy*
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Arab; Asia; Parkinson’s disease; fluctuations; non-motor; screening tools; wearing-off