Melevodopa/carbidopa effervescent formulation in the treatment of motor fluctuations in advanced Parkinson's disease

Whilst levodopa remains the gold standard treatment for the motor symptoms of Parkinson’s disease, prolonged use, such as occurs in patients in advanced stages of the disease, is associated with significant motor complications such as increased off time. In a randomized, double-blind, double-dummy, controlled parallel group study, the effectiveness of a readily soluble formation of melevodopa/caribdopa (M/C) in reducing off time has been compared to a conventional oral formulation of levodopa/caribdopa (L/C). Whilst M/C significantly reduced the baseline off time, which remained unchanged in L/C treated patients, the reduction in daily off time was no different between the two treatments, although there was a clear trend in favour of the M/C preparation (P = 0.07). The authors conclude that whilst the primary endpoint was not reached, the trend toward reduced off time in M/C off time warrants further investigation.