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: Develop an optimization algorithm that individualizes the pharmacokinetics-pharmacodynamics (PKPD) infusion models of levodopa, to improve the efficacy of dose titration and reduce the number of dose-adjustment days.
Background: Levodopa dose-titration is a commonly used process to determine which dose results in optimal symptom reduction and avoidance of side effects. Due to the large variation between individuals, the need of patient-specific dosing routines is of great interest. Individual optimization is achieved by minimizing the motor fluctuations and maximizing the “on-state” time.
Methods: Using an established pharmacokinetics-pharmacodynamics model with population mean parameters, we estimate what the mean population effect would be for a given dose. Applying different optimization algorithms the focus is to alter targeted parameter values that capture the observed behavior using only a few days of the titration duration. Based on these parameters, the algorithm makes optimized patient-specific dosing suggestions.
Results: Working with a simulated dataset, the estimated individual parameter values obtained from the algorithm are compared to the true individual parameters. Preliminary results confirm the ability of the algorithm to approximate the true underlying parameters using only a subset of the usual dose-titration period, yielding patient-specific suggestions for either discretized or continuous infusion. The number of steps of the optimization algorithm are considered as the needed number of titration days to make accurate predictions.
Conclusions: In the presented work we discuss the performance of the proposed approach and highlight its strengths and limitations. Using the optimization algorithm as described, the benefits for patients and hospitals could be significant. The next step is to test the performance of the algorithm in a clinical study.
To cite this abstract in AMA style:
I. Thomas, M. Alam, D. Nyholm, M. Senek, J. Westin. Minimizing levodopa titration period for Parkinson’s disease (PD) [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/minimizing-levodopa-titration-period-for-parkinsons-disease-pd/. Accessed May 19, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/minimizing-levodopa-titration-period-for-parkinsons-disease-pd/