touchROUNDTABLE The impact of delayed ON: Treating OFF episodes in patients with Parkinson’s disease
Leading experts Stuart Isaacson MD, Yasar Torres-Yaghi MD, Rajesh Pahwa MD discuss how to reduce the impact of delayed ON in Parkinson’s disease
Dr Stuart Isaacson
Parkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, FL, USA
Welcome and introduction
Dr Isaacson provides an overview of the changing response to levodopa over time and the types of OFF episodes, which patients may experience.1/7 Next Chapter
The impact of OFF Episodes, Including Delayed ON
Dr Yasar Torres-Yaghi describes the incidence of OFF episodes, the relationship between quality of life and OFF episodes, and the contribution of delayed ON to daily OFF time based on data from various studies (including observational studies) and surveys.2/7 Next Chapter
The current treatment approach to OFF
Dr Pahwa outlines the goals of treating OFF, the impact of existing therapies on OFF episodes, and a potential shift in treatment paradigm for OFF episodes.3/7 Next Chapter
Panel discussion: how to identify the type of OFF and select an intervention
The panel discusses how to identify which type of OFF episodes a patient is experiencing and how to select an appropriate intervention.4/7 Next Chapter
Selecting patients: Delphi Panel on the Pharmacological Approach to OFF Episodes in PD
Dr Isaacson provides an overview of the methodology and results of a Delphi panel to develop a consensus on when on-demand therapies should be considered for the treatment of OFF episodes.5/7 Next Chapter
Panel discussion: how to select patients
The panel discusses how to select patients who may benefit from on-demand therapy.6/7 Next Chapter
Conclusions and close
The panel conclude discussions with the key take-home messages.7/7 Leave Feedback
Learning Objectives & Overview
The consistent beneficial effect of each levodopa dose is reduced with Parkinson’s disease progression leading to increased frequency of cycling between ON and OFF states.1 OFF episodes can result from delayed onset of response to a levodopa dose (delayed ON).1 On-demand treatments can provide an acute conversion from OFF to ON for all types of OFF episodes, and can serve as a complementary therapy to address delayed time to ON.1–5 In this activity, leading experts provide guidance on when to use on-demand therapy and which patients may benefit.
After watching this activity, participants should be better able to:
- Outline the impact of delayed ON in the context of the total daily OFF time experienced by a patient.
- Discuss potential changes in treatment approach based on the type of OFF experienced by patients.
- Identify patients who may benefit from an on-demand therapy for OFF based on the findings of an expert consensus panel.
Faculty & Disclosures
Dr Stuart Isaacson
Parkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, FL, USA
Dr Isaacson is a neurologist specializing in Parkinson’s disease and movement disorders, and Medical Director of the Parkinson’s Research and Education Foundation. He has been involved in over 75 clinical trials and has authored or nearly 100 journal articles, book chapters and abstracts. He has also served on national and international committees for drug development programs and trials, as well as for the Parkinson Study Group and the movement disorders section of the American Academy of Neurology.
Honoraria for CME, consultant, research grants, and/or promotional speaker on behalf of: Abbvie, Acadia, Acorda, Adamas, Addex, Affiris, Alexza, Allergan, Amarantus, Amneal, Aptinyx, Axial, Axovant, Benevolent, Bial, Biogen, Biovie, Britannia, Cadent, Cala, Cerecor, Cerevel, Cipla, Eli Lilly, Enterin, GE Healthcare, Global Kinetics, Impax, Impel, Intec Pharma, Ipsen, Jazz, Kyowa Kirin, Lundbeck, Merz, Michael J. Fox Foundation, Mitsubishi Tanabe, Neuralys, Neurocrine, Neuroderm, Novartis, Parkinson Study Group, Pharma2B, Praxis, Prilenia, Promentis, Revance, Roche, Sage, Sanofi, Scion, Stoparkinson, Sunovion, Sun Pharma, Supernus, Teva, Theravance and Transposon.
Dr Yasar Torres-Yaghi
Department of Neurology, Medstar Georgetown University Hospital, Washington D.C, USA
Dr Torres-Yaghi is an expert in movement disorders at Medstar Georgetown University Hospital. He completed a fellowship at MedStar Georgetown University Hospital in neuro-restoration research. Dr Torres-Yaghi is also leading a research initiative to care for aging patients with neurodegenerative conditions with overlapping features of both cognitive impairment and Parkinson’s disease.
Honoraria from Sunovion.
Dr Rajesh Pahwa
University of Kansas Medical Center, Movement Disorders Division, Kansas City, KS, USA
Dr Rajesh Pahwa is Professor of Neurology and Director of Parkinson Foundation Center of Excellence at the University of Kansas Medical Center. He has conducted more than 75 clinical trials related to Parkinson’s disease and other movement disorders and published more than 250 peer-reviewed articles, chapters and abstracts in leading neurology and movement disorder journals.
Consultant for Abbott, AbbVie, ACADIA, Acorda, Allevion, Amneal, Artemida, Avion, BioVie, CalaHealth, Global Kinetics, Insightec, Jazz, Kyowa, Neurocrine, Neuroderm, PhotoPharmics, Sage, Sunovion, Supernus, UCB and Wren. Research support from Abbott, AbbVie, Addex, Biogen, Biohaven, Boston Scientific, EIP, Global Kinetics, Impax, Intec, Lilly, Neuroderm, Neuraly, Parkinson’s Foundation, Pharma 2B, Prelinia, Roche, Sage, SIS, Sun Pharma, Sunovion, Theranexus, Theravance, and Voyager.
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