MDS Abstracts

Abstracts from the International Congress of Parkinson’s and Movement Disorders.

MENU 
  • Home
  • Meetings Archive
    • 2024 International Congress
    • 2023 International Congress
    • 2022 International Congress
    • MDS Virtual Congress 2021
    • MDS Virtual Congress 2020
    • 2019 International Congress
    • 2018 International Congress
    • 2017 International Congress
    • 2016 International Congress
  • Keyword Index
  • Resources
  • Advanced Search

Impact of istradefylline on the adjustment of levodopa dose escalation in Parkinson’s disease: Results of the ISTRA ADJUST PD randomized, controlled study

T. Hatano, O. Kano, R. Sengoku, N. Yanagisawa, H. Nagayama (Tokyo, Japan)

Meeting: 2022 International Congress

Abstract Number: 724

Keywords: Adenosine antagonists, Levodopa(L-dopa), Parkinson’s

Category: Parkinson’s Disease: Clinical Trials

Objective: To evaluate the effect of istradefylline (IST), an adenosine A2A receptor antagonist, on the adjustment of levodopa dose escalation in patients with Parkinson’s disease (PD) with wearing-off phenomena.

Background: Clinical data suggest using the lowest possible levodopa dose to balance treatment benefits against the risk of motor complications. IST is approved in Japan and the US as adjunctive treatment to levodopa/decarboxylase inhibitors in PD patients with wearing-off phenomena/off episodes. There is a lack of robust data on the impact of IST on levodopa dose titration.

Method: In this multicenter, randomized, open-label, parallel-group controlled study, 114 PD patients with wearing-off phenomena receiving 300–400 mg/day levodopa were randomly assigned (1:1) to an IST or control group [figure1]. Levodopa dose escalation occurred based on clinical impression of severity. The primary endpoint was the cumulative additional levodopa dose throughout the 37-week (W) treatment period. Changes in symptom rating scales, motor activity using a wearable device, and safety outcomes were evaluated as secondary endpoints.

Results: In total, 105 patients (IST=52, control=53) were included in the efficacy and safety analyses. The cumulative additional levodopa dose as area under the curve was significantly lower by 5-fold in the IST vs. control group (p<0.0001, Mann–Whitney U test). Between 4W and 36W, the number of days to the first levodopa dose increase did not significantly differ between groups; 36.5% in the IST group and 47.2% in the control group had increased levodopa doses by 36W. Changes in secondary efficacy endpoints such as Movement Disorders Society-Unified Parkinson’s Disease Rating Scale from baseline were comparable between groups. Device-evaluated motor activities showed significant improvements from baseline to 36W only in the IST group. Incidences of adverse drug reactions (ADRs) were 28.8% in the IST group and 13.2% in the control group. No serious ADRs were observed in either group.

Conclusion: IST treatment was effective in the adjustment of levodopa dose escalation, resulting in less cumulative use of levodopa during the study. Data from the wearable device suggest that more objective improvement in motor function may be achieved with IST than with levodopa dose increase.

Hatano et al ISTRA abstract fig1

To cite this abstract in AMA style:

T. Hatano, O. Kano, R. Sengoku, N. Yanagisawa, H. Nagayama. Impact of istradefylline on the adjustment of levodopa dose escalation in Parkinson’s disease: Results of the ISTRA ADJUST PD randomized, controlled study [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/impact-of-istradefylline-on-the-adjustment-of-levodopa-dose-escalation-in-parkinsons-disease-results-of-the-istra-adjust-pd-randomized-controlled-study/. Accessed June 17, 2025.
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-istradefylline-on-the-adjustment-of-levodopa-dose-escalation-in-parkinsons-disease-results-of-the-istra-adjust-pd-randomized-controlled-study/

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
    • #25062 (not found)
    • Welcome to the MDS Abstracts Site
    • Effect of marijuana on Essential Tremor: A case report
    • Advanced Search
    • Increased Risks of Botulinum Toxin Injection in Patients with Hypermobility Ehlers Danlos Syndrome: A Case Series
    • Covid vaccine induced parkinsonism and cognitive dysfunction
    • Help & Support
    • About Us
    • Cookies & Privacy
    • Wiley Job Network
    • Terms & Conditions
    • Advertisers & Agents
    Copyright © 2025 International Parkinson and Movement Disorder Society. All Rights Reserved.
    Wiley