進行期Parkinson病における新規抗Parkinson病薬の役割

抄録

Since Prof. David Marsden pointed out the challenges (i.e. motor complications) associated with long–term L–dopa therapy in 1977, various efforts and innovations have been made to overcome motor complications. This article focuses on the role of novel anti–parkinsonian drugs in advanced Parkinson Disease (PD), including those approved and under development overseas. It is important to achieve continuous dopaminergic stimulation (CDS) in order to improve motor complications. Treatment strategies to achieve CDS with novel drugs include optimization of L–dopa delivery, optimization of L–dopa pharmacokinetics, parenteral administration of short–acting dopamine agonists, and oral administration of long–acting dopamine agonists. Amantadine extended release has been developed for levodopa–induced dyskinesia. L–dopa inhalation powder and apomorphine sublingual film are approved and marketed overseas as rescue drug for off–period.