Approaches to Parkinson’s disease treatment
Ohara Pharmaceutical Co., Ltd. contributes to improving the quality of life of the patients with Parkinson’s disease by providing drugs that play central roles in Parkinson’s disease treatment; we provide levodopa agents and agents act as dopamine agonist containing pramipexole.
Parkinson’s disease is the second most frequent neurodegenerative disease after Alzheimer’s dementia. In addition to motor symptoms such as tremor, Parkinson’s disease shows also various non-motor symptoms including autonomic disturbances and sleep disorders. The disease develops due to depletion of dopamine, a neurotransmitter, in the brain. The prevalence of Parkinson’s disease is considered to be 150 to 200 per 100,000 population. Parkinson’s disease increases with age, and the incidence in persons aged 80 or older may be 1,000 times higher than persons under age 40.
Pharmacological therapy is the principal strategy for management of Parkinson’s disease. Levodopa that supplies the decreased dopamine in the brain especially shows a high level of effectiveness with respect to the symptomatic treatment of parkinsonian motor features.
It is estimated that the number of patients in the major 10 nations in the world will be more than double from 4.1 million of 2005 to 8.7 million in 2030. Furthermore, the number of demented patients with Parkinson’s disease has also been increased in accordance with the aging or the prolonged treatment period in patients with Parkinson’s disease.
Message from Dr. Nobutaka Hattori
2017 is a symbolic year that will be exactly 200 years since Parkinson’s disease was first reported by James Parkinson. At the present time, there is no complete cure for Parkinson’s disease. With the progress of research and the developments of pharmacologic treatment and functional neurosurgery including deep brain stimulation (DBS), however, the deterioration of motor functions may be suppressed by early diagnosis and subsequent therapeutic interventions.
In pharmacologic management of Parkinson’s disease, levodopa shows highly efficacy for improvement of motor features and is a “gold standard” in the treatment strategies. In fact, before levodopa-era, the survival rate of patients was approximately 70% for 5 years and approximately 40% for 10 years. However, it is reported that in post-levodopa era, these rates have been increased to approximately 90% and 65%, respectively. Dopamine agonists also play a central role in treatment of motor features in Parkinson’s disease.
Recently, the concept of Continuous Dopaminergic Stimulation (CDS) attracts attention as corresponding to motor complications including wearing-off phenomenon that is a troublesome complication related to dopaminergic therapy of Parkinson’s disease in advanced stage.
Advances in pharmaceutical preparation on the basis of the concept of CDS contribute to the development of extended-release dopamine agonists. Recently, the administration system of levodopa intestinal gel delivered directly to the proximal jejunum is also clinically available in Japan.
Furthermore, combination therapy with dopaminergic agents, such as levodopa and dopamine agonists, and non-dopaminergic agents that act indirectly in dopaminergic system/metabolism is also an additional treatment strategy.
Living with hope is the most important in patients with Parkinson’s disease receiving medical treatment. For smile and peace in life of patients with Parkinson’s disease, we give advices to the latest treatment of Parkinson’s disease and home care in each individual as experts.
From April 2014, The Department of Neurology, Juntendo University set up a new research laboratory with a view all to the stage of cell transplantation therapy for Parkinson’s disease using induced pluripotent stem (iPS) cells. It is our important mission to deliver a new treatment method to patients with Parkinson’s disease as soon as possible.
Professor Nobutaka Hattori,
Department of Neurology, Faculty of Medicine,
Professor, Department of Neurology, Faculty of Medicine, Juntendo University
The Japanese Society of Neurology (Executive Board Member), Movement Disorders Society, (Archives Committee), Movement Disorders Society Asian & Oceanian Section (Chair-Elect), American Neurological Association (Corresponding fellow), Japanese Society of Neurological Therapeutics (Councilor), Movement Disorders Society Japan (Executive Committee), etc.