Istradefylline has been developed as an add-on treatment for adult patients receiving levodopa-based regimens for Parkinson’s disease (PD), who are experiencing end of dose fluctuations. PD is neurodegenerative condition resulting from the loss of the dopamine-containing cells of the substantia nigra. There is no cure for PD and symptoms are usually seen in motor-development and include bradykinesia and tremor. OFF periods of treatment occur when the levodopa treatment provided starts to wear off, usually after long term use.
Istradefylline is a selective adenosine A2A receptor inhibitor; these receptors are found in the region of the brain that suffers degeneration in PD. The treatment works by increasing the levels of dopamine in the substantia nigra. Current treatment for PD is associated with adverse events. Several phase III clinical trials have shown istradefylline, when taken orally, to be safe and effective in the treatment of PD during OFF periods. If licensed, istradefylline will provide a new therapeutic option to managing people with Parkinson’s as the first non-dopaminergic add-on treatment.