Aim: To further evaluate the efficacy of foslevodopa/foscarbidopa (LDp/CDp), a soluble formulation of levodopa/carbidopa (LD/CD) prodrugs delivered continuous subcutaneous infusion, for people with advanced Parkinson’s disease (PwaPD).
Methods: PwaPD with ≥ 2.5 hours “Off” time/day were enrolled in 2 phase 3 trials investigating LDp/CDp [1, 2]. PwaPD were randomized 1:1 to LDp/CDp or oral immediate-release (IR) LD/CD in the 12-week double-blind study (NCT04380142) [2]; in the 52-week study all PwaPD received open-label LDp/CDp (NCT03781167) [2]. Effect size, NNT, and change from baseline (BL) were evaluated post hoc for “Off”/“On” times, daily activities (MDS-UPDRS Part II), sleep (PDSS-2), and quality of life (PDQ-39).
Results: This analysis includes 141 PwaPD from the 12-week study, and 244 PwaPD (LDp/CDp) from the 52-week study. Within-group effect size showed a benefit of LDp/CDp vs oral IR LD/CD at week 12 for reduction in “Off” time (–0.7 vs –0.3) and improvements in “On” time without troublesome dyskinesia (0.7 vs 0.2. At week 12, the NNT for minimum clinically important differences in “Off” time (reduced ≥ 1 hour) and “On” time without troublesome dyskinesia (improved ≥ 1 hour) was lower with LDp/CDp (1.5 and 1.6) vs oral IR LD/CD (2.5 and 2.4).
Conclusions: In PwaPD, LDp/CDp demonstrated improved motor function, daily activities, sleep, and quality of life vs PwaPD on oral IR LD/CD when assessed by effect size, NNT, and percent change from BL.