title: First clinical experience with levodopa/carbidopa microtablets in Parkinson's disease.
abstract: BACKGROUND
  Levodopa is the most effective symptomatic treatment throughout the course of Parkinson's disease, but as the disease progresses, there may be a need for individualized, fine-tuned treatments.
  
  
  OBJECTIVE
  To evaluate individualized levodopa/carbidopa dosing using microtablets dispensed with a dose dispenser, with respect to efficacy and usability as perceived by patients.
  
  
  METHODS
  Patient records and dose dispenser reports from patients previously or currently treated with microtablets and a dose dispenser were reviewed, and a patient questionnaire concerning effect and usability was sent to patients.
  
  
  RESULTS
  Eleven patient records, four dose dispenser reports and nine survey responses were obtained. The treatment effect was considered to be improved by six of nine patients. One-third found their bradykinesia to be improved, and the non-troublesome dyskinesia was unchanged according to a majority of patients; however, some experienced the duration and magnitude of troublesome dyskinesia to be worse. The usability was generally rated as good. The four dose dispenser reports obtained showed 97(±5)% total adherence.
  
  
  CONCLUSIONS
  The experienced effect of treatment can, for some patients, be improved by the use of microtablets, and the dose dispenser was considered user-friendly. Further studies with a larger study population and prospective design are needed to confirm the results.
authors.affiliation: Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-0302-6946
authors.initials: M
authors.lastname: Senek
authors.affiliation: Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Hellström
authors.affiliation: Vällingby Läkarhus, Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Albo
authors.affiliation: Karolinska Institutet, Huddinge, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Svenningsson
authors.affiliation: Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Nyholm
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002230:Carbidopa / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D013607:Tablets
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; D013607:Tablets; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa
keywords: Parkinson's disease; carbidopa; dose dispenser; levodopa; microtablets; pharmacotherapy