Session Information
Date: Thursday, June 23, 2016
Session Title: Parkinson's disease: Clinical trials, pharmacology and treatment
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate the efficacy of istradefylline, a selective adenosine A2A receptor antagonist, for fatigue and depression in Parkinson’s disease (PD) patients.
Background: Istradefylline is a non-dopaminergic treatment option to current PD therapy only in Japan, however, its clinical efficacy to non-motor symptoms in PD has not been elucidated.
Methods: This study is a prospective, open-labeled, non-randomized trial. Eligible subjects met UK Parkinson’s disease Society Brain Bank criteria, had to be 21 years or older; with the score of mini-mental examination study was 24 or higher. After we got written informed consent, we administered 20 mg/day of istradefylline for 4 weeks followed with 40mg/day of istradefylline for 4 weeks as an adjunct to levodopa in sporadic PD patient with motor fluctuations. We evaluated UPDRS part III subscale score (on-state), Parkinson Fatigue Scale (PFS-16), Patient Health Questionnaire (PHQ-9), and adverse events. This study was approved by Tokushukai Medical Alliance Review Board.
Results: As for 1st January 2016, 14 patients were enrolled (9 male and 5 female, 72.1±5.7 y.o., time since onset 93.8±61.5 months). UPDRS part III subscale score reduced 22.6±11.6 to 11.1±7.2 with 20mg/day of istradefylline. PFS-16 reduced in 3 patients and daytime drowsiness resolved in 1 of 3 patients. In addition, PHQ-9 reduced in 3patients and daytime drowsiness resolved or reduced in 2 of 3 patients. No serious adverse events were observed.
Conclusions: We could not exclude the placebo effect, however, istradefylline 20mg/day improved the motor function of PD patients. Istradefylline could regulate the sleep-wake behavior to antagonize the Adenosine A2A receptor in the nucleus accumbence which was considered to play an integral part of sleep-wake regulatory network. Daytime drowsiness might have some relations with fatigue and depression in several PD patients and istradefylline could be effective for these non-motor symptoms.
To cite this abstract in AMA style:
H. Ito, T. Kamei. Adenosine A2A receptor antagonist istradefylline might have efficacy to fatigue and depression in some patients of Parkinson’s disease [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/adenosine-a2a-receptor-antagonist-istradefylline-might-have-efficacy-to-fatigue-and-depression-in-some-patients-of-parkinsons-disease/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/adenosine-a2a-receptor-antagonist-istradefylline-might-have-efficacy-to-fatigue-and-depression-in-some-patients-of-parkinsons-disease/