Abstract：
BACKGROUND: Parkinson\'s disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, primarily because of the impairment of dopaminergic neurons. Long-term use of levodopa, the standard PD treatment, often results in fluctuating therapeutic effects and dyskinesia, necessitating alternative therapies.
OBJECTIVE: This review aims to synthesize current insights and clinical experiences with foslevodopa-foscarbidopa, focusing on its pharmacokinetics, efficacy, and safety profile, to evaluate its potential in transforming PD therapy.
METHODS: A systematic literature search was conducted up to November 2023 using databases PubMed, Web of Science, and Cochrane Library. The search yielded eight eligible articles, including pharmacological studies, case reports, observational studies, and controlled trials. No language restrictions were applied.
RESULTS: Foslevodopa and foscarbidopa, as prodrugs of levodopa and carbidopa, exhibited excellent chemical stability and solubility, facilitating continuous subcutaneous infusion. Clinical trials demonstrated that these prodrugs maintain stable levodopa levels, thereby addressing the limitations of oral levodopa therapy. Phase 1 and 3 studies indicated significant improvements in motor function and quality of life in advanced PD patients. However, a higher incidence of treatment-emergent adverse events, mainly infusion site reactions, was observed compared to oral therapies.
CONCLUSIONS: Foslevodopa-foscarbidopa emerges as a promising alternative for advanced PD treatment, offering sustained symptom control. Its efficacy in managing motor fluctuations and dyskinesia makes it a viable option in the PD therapeutic spectrum. Future research should focus on long-term safety, economic impact, and broader accessibility. Foslevodopa-foscarbidopa is now commercially distributed in many countries in Europe and in Japan.
OBJECTIVE: This review aims to synthesize current insights and clinical experiences with foslevodopa-foscarbidopa, focusing on its pharmacokinetics, efficacy, and safety profile, to evaluate its potential in transforming PD therapy.
METHODS: A systematic literature search was conducted up to November 2023 using databases PubMed, Web of Science, and Cochrane Library. The search yielded eight eligible articles, including pharmacological studies, case reports, observational studies, and controlled trials. No language restrictions were applied.
RESULTS: Foslevodopa and foscarbidopa, as prodrugs of levodopa and carbidopa, exhibited excellent chemical stability and solubility, facilitating continuous subcutaneous infusion. Clinical trials demonstrated that these prodrugs maintain stable levodopa levels, thereby addressing the limitations of oral levodopa therapy. Phase 1 and 3 studies indicated significant improvements in motor function and quality of life in advanced PD patients. However, a higher incidence of treatment-emergent adverse events, mainly infusion site reactions, was observed compared to oral therapies.
CONCLUSIONS: Foslevodopa-foscarbidopa emerges as a promising alternative for advanced PD treatment, offering sustained symptom control. Its efficacy in managing motor fluctuations and dyskinesia makes it a viable option in the PD therapeutic spectrum. Future research should focus on long-term safety, economic impact, and broader accessibility. Foslevodopa-foscarbidopa is now commercially distributed in many countries in Europe and in Japan.
摘要：
背景：帕金森病（PD）是一种以运动和非运动症状为特征的进行性神经退行性疾病，主要是因为多巴胺能神经元受损。长期使用左旋多巴，标准的PD治疗，通常会导致治疗效果波动和运动障碍，需要替代疗法。
目的：这篇综述旨在综合目前对foslevodopa-foscabidopa的见解和临床经验，专注于它的药代动力学，功效,和安全概况，评估其转化PD治疗的潜力。
方法：截至2023年11月，使用PubMed数据库进行了系统的文献检索，WebofScience,科克伦图书馆搜索产生了八篇符合条件的文章，包括药理学研究，病例报告,观察性研究，和对照试验。未应用语言限制。
结果：Foslevodopa和foscabidopa，作为左旋多巴和卡比多巴的前药，表现出优异的化学稳定性和溶解性，促进持续皮下输注。临床试验表明，这些前药保持稳定的左旋多巴水平，从而解决口服左旋多巴治疗的局限性。1期和3期研究表明，晚期PD患者的运动功能和生活质量显着改善。然而,治疗引起的不良事件发生率较高，主要是输液部位反应,与口服疗法相比，观察到。
结论：Foslevodopa-foscabidopa成为晚期PD治疗的有希望的替代药物，提供持续的症状控制。其在管理运动波动和运动障碍方面的功效使其成为PD治疗谱中的可行选择。未来的研究应该集中在长期的安全性，经济影响,和更广泛的可访问性。Foslevodopa-foscabidopa现在在欧洲和日本的许多国家进行商业销售。
目的：这篇综述旨在综合目前对foslevodopa-foscabidopa的见解和临床经验，专注于它的药代动力学，功效,和安全概况，评估其转化PD治疗的潜力。
方法：截至2023年11月，使用PubMed数据库进行了系统的文献检索，WebofScience,科克伦图书馆搜索产生了八篇符合条件的文章，包括药理学研究，病例报告,观察性研究，和对照试验。未应用语言限制。
结果：Foslevodopa和foscabidopa，作为左旋多巴和卡比多巴的前药，表现出优异的化学稳定性和溶解性，促进持续皮下输注。临床试验表明，这些前药保持稳定的左旋多巴水平，从而解决口服左旋多巴治疗的局限性。1期和3期研究表明，晚期PD患者的运动功能和生活质量显着改善。然而,治疗引起的不良事件发生率较高，主要是输液部位反应,与口服疗法相比，观察到。
结论：Foslevodopa-foscabidopa成为晚期PD治疗的有希望的替代药物，提供持续的症状控制。其在管理运动波动和运动障碍方面的功效使其成为PD治疗谱中的可行选择。未来的研究应该集中在长期的安全性，经济影响,和更广泛的可访问性。Foslevodopa-foscabidopa现在在欧洲和日本的许多国家进行商业销售。
