New therapeutic perspectives in advanced Parkinson’s disease: тhe role of foslevodopa/foscarbidopa

Abstract

Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder that primarily affects dopaminergic neurons in the brain, leading to a complex set of motor and non-motor symptoms. As the disease advances, symptoms progress and result in significant disability.
This is due to a combination of progressive nigrostriatal dopaminergic degeneration, ineffective absorption of oral levodopa medications, and the short halflife of these drugs within a narrow therapeutic window. In the advanced stages of the disease, continuous dopaminergic stimulation becomes a key therapeutic goal.
Recently, a “new star” has been added to the already wellknown arsenal of treatment methods for advanced PD – a subcutaneous solution of the prodrugs foslevodopa and foscarbidopa.
Device-assisted therapy with foslevodopa/foscarbidopa is an individualized continuous subcutaneous thera py for patients with advanced Parkinson’s disease who respond well to levodopa but whose motor fluctuations are not adequately controlled with optimal doses of oral medications. Compared to other well-known therapies for advanced PD, continuous subcutaneous infusion of LDp/CDp offers a less invasive alternative, making it a more suitable option for certain patient populations.
This article aims to summarize the available published data on the effectiveness, safety profile, and tolerability of this method. It provides practical guidance on managing the most common adverse events and selecting eligible patients. More extensive and long-term comparative studies are needed to establish the advantages and disadvantages of this method compared to well-established therapies for advanced PD, to define an optimal patient profile, and to assess its long-term benefits and risks.