Objective: To determine if adults with advanced Parkinson’s disease (aPD) treated with a 24‑hour/day continuous subcutaneous foslevodopa/foscarbidopa (LDp/CDp) infusion who had ≥ 1‑hour improvement in good “On” time from baseline, compared to those who did not, were more likely to improve on the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale subscale I (MDS-UPDRS-I: Nonmotor Experiences of Daily Living)[1] and the Parkinson’s Disease Questionnaire (PDQ‑39)[2,3].

Background: LDp/CDp has been shown to be safe and effective in clinical trials; however, the relation of improvement of motor fluctuations with improvement of nonmotor symptoms (NMS) and quality of life (QoL) has not been investigated.

Method: Data were pooled from a 12-week randomized active-controlled trial (NCT03781167) and a 52-week open‑label safety trial (NCT04380142) to assess improvement from baseline to week 12 in NMS (defined as ≥ 1-point decrease on MDS-UPDRS-I single items or ≥ 2.64 decrease in total score) and QoL (defined as ≥ 1-point decrease on PDQ‑39 single items or ≥ 4.72 decrease in total score) in patients with ≥ 1 hour of improvement in good “On” time.

Results: Results: Participants with improvement in their amount of “On” time (N = 115 / 153) were significantly more likely to have ≥ 1 point improvement on the MDS-UPDRS-I single item of fatigue (41.7% vs 21.1%, P = .022), on numerous PDQ‑39 single items (Table 1), and total PDQ‑39 summary index score (64.3% vs 29.7%, P ≤ .001) than those without “On” time improvement. Further, participants with “On” time improvement compared to those without had numerically greater improvement in MDS‑UPDRS-I total score (least square [LS] mean ‑2.26 vs ‑0.54, P = .065) and significantly greater improvement in PDQ‑39 total score (LS mean ‑9.67 vs 0.32, P ≤ .001). Participants with an improvement of ≥ 2.64 points on MDS‑UPDRS-I score, compared to those without, were significantly more likely to experience ≥ 4.72 points improvement on PDQ‑39 total score (72.2% versus 53.7%, P = .006).

Conclusion: This preliminary analysis suggests that adults with aPD treated with LDp/CDp who had improved “On” time also experienced improvements in NMS and QoL, and that MDS‑UPDRS I subscale improvement may be related to PDQ-39 improvement in these patients, meriting further research.

Table 1

References: 1. Goetz CG, et al. Mov Disord. 2008;23(15):2129-2170.
2. Jenkinson C, et al. Age Ageing. 1995;24(6):505-509.
3. Peto V, et al. Qual Life Res. 1995;4(3):241-248.
4. Jenkinson C, et al. Age Ageing. 1997;26(5):353-357.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-improvement-in-on-time-nonmotor-symptoms-and-quality-of-life-in-adults-treated-with-foslevodopa-foscarbidopa-in-advanced-parkinsons-disease/