title: The efficacy of oral adenosine A(2A) antagonist istradefylline for the treatment of moderate to severe Parkinson's disease.
abstract: The moderate and severe stages of Parkinson's disease (PD) are marked by motor and non-motor complications that still remain difficult to control with the currently available therapy. Adenosine A(2A) receptor antagonists target non-dopaminergic systems, and have emerged as promising add-on therapy in the management of PD, a little more than a decade ago. While the development of this new drug class was slower than initially expected, istradefylline was recently registered in Japan, because it provides reduction of the off-time, when given in association with levodopa. Effects on some non-motor features have also been suggested, and preliminary studies further suggest a potential neuroprotective effect. Associations of A(2A) receptor antagonists with dopaminergic agents, as well as enzyme blockers like catechol-O-methyltransferase (COMT) and monoamine oxidase-B (MAO-B) inhibitors, should provide even greater benefit in advanced PD patients, and, thus, a more individualized treatment approach would be at hand.
authors.affiliation: a University of Medicine and Pharmacy "Victor Babes"; County Hospital , Department of Neurology , Timisoara , Romania.|b Parkinson and Movement Disorders Unit , IRCCS Hospital San Camillo , Venice , Italy.
authors.forename: Ruxandra Julia
authors.initials: RJ
authors.lastname: Vorovenci
authors.affiliation: b Parkinson and Movement Disorders Unit , IRCCS Hospital San Camillo , Venice , Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Antonini
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use; D065098:Catechol O-Methyltransferase Inhibitors / Q000627:therapeutic use; D006801:Humans; D007564:Japan; D007980:Levodopa / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy*; D011687:Purines / Q000627:therapeutic use*
chemical_list: D000978:Antiparkinson Agents; D065098:Catechol O-Methyltransferase Inhibitors; D008996:Monoamine Oxidase Inhibitors; D011687:Purines; C111599:istradefylline; D007980:Levodopa
keywords: A2A receptor antagonist; Parkinson’s disease; dyskinesia; istradefylline; levodopa add-on therapy; motor fluctuations; off time; treatment