Real-world evidence on levodopa dose escalation in patients with Parkinson’s disease treated with istradefylline (Nourianz)

[Sydney75]

Interesting article. Nourianz is an add-on drug for PD, not covered by many insurance companies or Medicare in US, super $$$. However, because of a patent dispute, Nourianz will be eligible for patent challenges on August 27, 2023. This date may extended up to six months if a pediatric exclusivity extension is applied to the drug's patents. By analyzing the patents and regulatory protections it appears that the earliest date for generic entry will be November 13, 2024. The cost may be coming down in the near future. This real-world analysis of Japanese prescription data indicated that slowing of LDD escalation was observed in patients initiated on istradefylline, particularly in those receiving ≥600 mg/day levodopa, suggesting istradefylline may slow progressive LDD increases. These findings suggest that initiating istradefylline before other levodopa-adjunctive therapies may mitigate LDD increases, potentially reducing occurrence or severity of levodopa-induced complications in long-term istradefylline treatment.Article Link below:medrxiv.org/content/10.1101...