Session Information
Date: Thursday, June 8, 2017
Session Title: Parkinson’s Disease: Clinical Trials, Pharmacology And Treatment
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: This study analyzed the clinical effectiveness of istradefylline in terms of sleep disturbance in Parkinson’s disease (PD) patients.
Background: A selective adenosine A2A receptor antagonist, istradefylline, improves motor symptoms of PD by antagonizing A2A receptors in the striatum and globus pallidus. A2A receptors are also specifically presented at the nucleus accumbens which is an integral part of the sleep-wake regulatory network.
Methods: A before-after study. Subjects were PD patients with wearing-off by L-dopa treatment. Oral istradefylline 20mg/day was administered for 4-6 weeks. Sleep disturbance (PDSS-2), daytime sleepiness (ESS), QOL (PDQ-39), and global improvement of motor symptoms (CGI-I) were measured.
Results: The subjects were 12 patients (age 71(7)、H&Y 2.8(0.9); mean(SD)). Responder rate of motor improvement (CGI-I) by istradefylline treatment was 58%. The treatment did not worsen ESS (7.3(4.5)/6.3(6.1); before/after the treatment), PDSS-2 (19.9(8.5)/16.1(9.6), nor PDQ-39 (43.6(33.4)/39.8(31.3)). In 7 subjects with severe sleep disturbance (PDSS-2 ≧20), the treatment showed a larger responder rate of motor improvement (86%), did not worsen daytime sleepiness which was more serious than the other subjects with PDSS-2 <20, and improved restlessness of legs or arms (p=0.09) of PDSS-2 and stigma (p=0.03) and bodily discomfort (p=0.09) of PDQ-39.
Conclusions: In PD patients with wearing-off, istradefylline improves motor symptoms without worsening sleep disturbance, daytime sleepiness, or QOL. Even in the patients suffering from severe sleep disturbance, istradefylline does not worsen daytime sleepiness and yields more frequent clinical improvement.
References: In PD patients with wearing-off, istradefylline improves motor symptoms without worsening sleep disturbance, daytime sleepiness, or QOL. Even in the patients suffering from severe sleep disturbance, istradefylline does not worsen daytime sleepiness and yields more frequent clinical improvement.
To cite this abstract in AMA style:
K. Ohta, Y. Kujuro, T. Osada. Istradefylline improves not only motor symptoms but also sleep disturbance, daytime sleepiness, and QOL of Parkinson’s disease patients. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/istradefylline-improves-not-only-motor-symptoms-but-also-sleep-disturbance-daytime-sleepiness-and-qol-of-parkinsons-disease-patients/. Accessed May 18, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/istradefylline-improves-not-only-motor-symptoms-but-also-sleep-disturbance-daytime-sleepiness-and-qol-of-parkinsons-disease-patients/