In addition to these current treatments, innovation is ongoing in the area of addressing side effects. For an example of cutting-edge treatment, consider the case of Parkinson’s disease (PD). One PD side effect is “freezing” or “off” episodes, characterized by acute immobility, occurring between one and several times daily and lasting from one to several hours cumulatively. These episodes are triggered by levodopa or enzyme inhibitors—both mainline treatments for PD. The episodes begin when the levodopa or enzyme inhibitors enter the bloodstream too slowly, or wear off quickly, or just do not enter the bloodstream sufficiently at all.
The sole drug approved as an acute rescue therapy to treat these “off” episodes is the dopamine agonist apomorphine, (Apokyn® in the U.S. and Japan; Apo-go® in Europe and Asia). Apomorphine is primarily available in an inconvenient, painful injectable form (and as an abdominal infusion pump in Europe)—problematic not only because it requires administration up to several times daily, but also because the injection can result in (for approximately 70 percent of users) irritation and nodules at the injection site on the body, since apomorphine is only stable in a highly acidic formulation.
Approximately 40 percent of patients using Apokyn experience significant nausea for the first few months of treatment with it. As a countermeasure, they are prescribed the anticholinergic Tigan® (trimethobenzimide) in the U.S. a few days before beginning Apokyn, and within three to six months almost all no longer require Tigan.
Given the ongoing demand to address side effects of current and future mainstream drugs, the innovation embodied by the examples above will continue to be welcomed by healthcare providers and patient populations alike.