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Nervenheilkunde 2018; 37(04): 233-242
DOI: 10.1055/s-0038-1641240
Morbus Parkinson
Schattauer GmbH

Update Pharmakotherapie bei Parkinson

Pharmacotherapy in Parkinson’s disease
U. M. Fietzek
1   Schön Klinik München-Schwabing
,
A. O. Ceballos-Baumann
1   Schön Klinik München-Schwabing
› Institutsangaben
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Publikationsverlauf

eingegangen am: 01. Dezember 2017

angenommen am: 22. Dezember 2017

Publikationsdatum:
02. April 2018 (online)

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Zusammenfassung

Auch im letzten Jahr wurden zahlreiche pharmakotherapeutische Entwicklungen für die Parkinsonkrankheit vorangebracht. Die in den USA kommerziell erfolgreiche retardierte Darreichungsform von Levodopa IPX066 ist in Europa zwar zugelassen, aber nicht am Markt verfügbar. Eine speziell gefaltete Akkordeon Pille verspricht ebenso eine vereinfachte Galenik bei besserer klinischer Wirkung. Levodopa ist als Inhalativum kurz vor Markteintritt und zeigt in den vorgelegten Studien, dass Off-Phasen erfolgreich verkürzt werden können, allerdings nicht schnellere Hilfe leisten als die verfügbaren Stand-by Medikamente. Neu ist auch, dass L-Dopa über die Haut appliziert werden kann. Safinamid und Opicapon sind über Rezept verfügbar. Für letzteres liegen die Ergebnisse der Zulassungsstudien vor. Die neue AmantadinGalenik hat in den USA aufgrund günstiger Studiendaten die Zulassung zur Behandlung von Dyskinesien erhalten. Auch hat sich das Verständnis um Risikofaktoren zur Entwicklung eines Parkinson deutlich weiterentwickelt. Wir stellen neueste Arbeiten zu dem Glucagon-like-Peptid-Analogon Exenatide und dem ß2-Adrenorezeptor vor.

Summary

During the last year numerous pharmacotherapeutic developments have taken place in the field of Parkinson’s disease (PD). The commercially successful IPX066 is a levodopa formulation with controlled release that is registered in Europe but not marketed. A specially folded accordion levodopa pill promises easier use and improved clinical efficacy. Levodopa is a now available to inhale, and has shown efficacy to shorten OFF phases. However, it is not faster than available rescue preparations such as the apomorphine pen. Another novelty is the Neuroderm pump that delivers levodopa subcutaneously. Safinamide and opicapone are available by prescription. The data of the opicapone registration study is published by now. The new amantadine with controlled release has been registered for use in dyskinetic patients in the USA. Our understanding of the pathomechanisms and risk factors to develop PD has been expanded. We report the newest research concerning the glucagon-like-peptide analogue exenatide and the ß2-adrenoreceptor.

SchlüsselWörter

Parkinson - Pharmakotherapie - Levodopa - motorische Komplikationen - Schmerz - Psychose

Keywords

Parkinson’s disease - pharmacotherapy - levodopa - motor complications - pain - psychosis
 

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