Side Effects of levodopa oral inhalation: A Synthesis of Findings from 3 Studies

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Original Abstract of the Article

Key Findings

CVT-301 (Inbrija®) is a levodopa inhalation powder for on-demand treatment of OFF episodes in Parkinson’s disease patients treated with carbidopa/levodopa. 1 Inhaled levodopa is an emerging therapeutic option in the treatment of “off” symptoms associated with Parkinson’s disease (PD). 3 Its mode of delivery offers more rapid absorption of levodopa and shorter onset of clinical benefit compared to oral formulations. 3 It has been shown to be feasible for use in patients with PD experiencing worse motor function due to declining plasma levodopa levels. 3

Reasons for Side Effects

Inhaled levodopa acts directly on the lungs, which may increase the likelihood of respiratory side effects. 2

Common Side Effects

Cough

Cough is a common side effect of inhaled levodopa. 3

Upper Respiratory Tract Infection

Upper respiratory tract infection is a common side effect of inhaled levodopa. 3

Nausea

Nausea is a common side effect of inhaled levodopa. 3

Sputum Discoloration

Sputum discoloration is a common side effect of inhaled levodopa. 3

Dyskinesia

Dyskinesia is a common side effect of inhaled levodopa. 3

Side Effect Management

Cough

Cough is a common side effect of inhaled levodopa. 3 To reduce cough, measures such as drinking water before inhalation and gargling after inhalation are effective. 3

Upper Respiratory Tract Infection

Upper respiratory tract infection is a common side effect of inhaled levodopa. 3 To prevent upper respiratory tract infection, measures such as hand washing and gargling and avoiding crowds are effective. 3

Nausea

Nausea is a common side effect of inhaled levodopa. 3 To reduce nausea, measures such as eating small meals and avoiding fatty foods are effective. 3

Sputum Discoloration

Sputum discoloration is a common side effect of inhaled levodopa. 3 Sputum discoloration is caused by levodopa acting on the lungs. 3 Long-term (up to 1 year) safety studies in otherwise-healthy asthmatics and smokers showed no long-term changes in pulmonary function or spirometry measures. 3

Dyskinesia

Dyskinesia is a common side effect of inhaled levodopa. 3 Dyskinesia may occur due to levodopa overdose. 3 To reduce dyskinesia, measures such as reducing the dose of levodopa are effective. 3

Comparison Between Studies

Similarities

The three studies aimed to evaluate the safety and efficacy of inhaled levodopa. 1 2 3 All three studies suggested that inhaled levodopa was effective in treating OFF episodes in patients with Parkinson’s disease. 1 2 3

Differences

The three studies differed in terms of the subjects, duration, administration methods and doses of inhaled levodopa. 1 2 3

Considerations for Real-World Application

Inhaled levodopa is a promising therapeutic option for treating OFF episodes in patients with Parkinson’s disease. 1 However, it may cause some side effects, such as cough and upper respiratory tract infection. 3 These side effects should be considered when using inhaled levodopa. 3 Inhaled levodopa may also be used in combination with other therapies. 2

Limitations of Current Research

Inhaled levodopa is still under development. 3 The long-term safety and efficacy of inhaled levodopa are not yet fully understood. 3

Future Research Directions

Research is needed to investigate the long-term safety and efficacy of inhaled levodopa. 3 Research is also needed to investigate the effects of inhaled levodopa when used in combination with other therapies. 2

Conclusion

Inhaled levodopa is a promising therapeutic option for treating OFF episodes in patients with Parkinson’s disease. 1 However, it may cause some side effects, such as cough and upper respiratory tract infection. 3 These side effects should be considered when using inhaled levodopa. 3 Further research is needed on the safety and efficacy of inhaled levodopa. 3

Literature analysis of 3 papers
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1.

A 12-month, dose-level blinded safety and efficacy study of levodopa inhalation powder (CVT-301, Inbrija) in patients with Parkinson's disease.

Author: FarbmanEric S, WatersCheryl H, LeWittPeter A, RudzińskaMonika, KlinglerMichael, LeeAngela, QianJenny, OhCharles, HauserRobert A

Improved ON states
Reduced OFF time
Pulmonary function decline

CVT-301 (Inbrija®), a levodopa inhalation powder, was well-tolerated for 12 months in patients with Parkinson's disease. The drug maintained improvement in achieving ON states and reducing daily OFF time.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Inhaled levodopa for intermittent treatment of OFF episodes in patients with Parkinson's disease.

Author: SimõesRita Moiron, Castro CaldasAna, FerreiraJoaquim J

Parkinson's disease treatment
Rapid symptom reversal
Pulmonary adverse events

Inhaled levodopa is a promising treatment for Parkinson's disease OFF periods, offering rapid symptom relief and potentially overcoming the limitations of oral administration.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Profile of inhaled levodopa and its potential in the treatment of Parkinson's disease: evidence to date.

Author: PatelAmi B, Jimenez-ShahedJoohi

PD treatment
Cough
Dyskinesia
Nausea
Upper respiratory infection

This article reviews the clinical development of inhaled levodopa, a newly emerging therapeutic option for the treatment of "off" symptoms associated with Parkinson's disease (PD).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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