Levodopa Inhalation Powder: A Review in Parkinson’s Disease
Compliance with Ethical Standards
Disclosure: The preparation of this review was not supported by any external funding.
Conflicts of interest: Julia Paik is a salaried employee of Adis/Springer, is responsible for the article content and declares no relevant conflicts of interest.
Additional information about this Adis Drug Review can be found here
Abstract
Levodopa
inhalation powder (Inbrija®) is approved for the intermittent treatment of OFF
episodes in patients with Parkinson’s disease (PD) treated with levodopa/dopa-decarboxylase
inhibitor (LD-DCI) in the EU and specifically with carbidopa/levodopa in the
USA. The approved dosage is 84 mg taken as needed up to five times a day.
Administered via a breath-actuated inhaler, this formulation enables levodopa to
bypass the gastrointestinal (GI) tract and, instead, rapidly enter the
bloodstream through the pulmonary system. In the 12-week, double-blind,
placebo-controlled, phase III SPAN-PD trial, as-needed levodopa inhalation
powder 84 mg improved motor symptoms during OFF periods in PD patients (aged
30–86 years) treated with levodopa and carbidopa or benserazide. The
likelihood of achieving an ON state 60 min postdose was significantly
higher in the levodopa inhalation powder than the placebo group, with most
patients in the levodopa inhalation powder group experiencing improvements in
PD symptoms. Findings from longer-term, 52-week phase III studies were
consistent with those from the SPAN-PD trial with regards to the treatment of
OFF episodes. Levodopa inhalation powder was generally well tolerated and did
not noticeably affect pulmonary function in PD patients. Providing a
nonintrusive, convenient treatment method, levodopa inhalation powder is a
promising option for the intermittent treatment of OFF episodes in patients
with PD treated with a LD-DCI.
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