ReviewClinical parkinsonism & related disorders2022
Should "on-demand" treatments for Parkinson's disease OFF episodes be used earlier?
Review in Clinical parkinsonism & related disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Long-term safety, tolerability and efficacy of apomorphine sublingual film in patients with Parkinson's disease complicated by OFF episodes: a phase 3, open-label study.Journal of neurology · 2024Trial
- On-demand therapies-emergency medication or daily routine?Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
- AI-Driven Analysis of Wrist-Worn Sensor Data for Monitoring Individual Treatment Response and Optimizing Levodopa Dosing in Parkinson's Disease.Sensors (Basel, Switzerland) · 2025Article
- Moving to a non-dopaminergic approach for the treatment of OFF fluctuations in Parkinson's disease.Clinical parkinsonism & related disorders · 2025Review
- Adherence and persistence with istradefylline treatment in patients with Parkinson's disease in the United States.Frontiers in pharmacology · 2025Article
- Clinicians' viewpoints on current paradigms of care and research in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2024Review
- Advanced Parkinson's disease treatment patterns in Italy: an observational study interim analysis.Annals of medicine · 2024Observational
- Clinical Use of On-Demand Therapies for Patients with Parkinson's Disease and OFF Periods.Neurology and therapy · 2023Review
- Inhaled levodopa for threatening impending OFF episodes in managing Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2023Review
- Drugs to the Rescue: Comparison of On-Demand Therapies for OFF Symptoms in Parkinson's Disease.Journal of Parkinson's disease · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We discuss a shift in the treatment paradigm for OFF episode management in patients with Parkinson's disease, based on clinical experience in the United States (US). Three "on-demand" treatments are currently available in the US as follows: subcutaneous apomorphine, levodopa inhalation powder, and sublingual apomorphine. We empirically propose that "on-demand" treatments can be utilized as a complementary treatment when OFF episodes emerge and can be utilized when needed rather than reserving these treatments only until other treatment approaches (adjustment of baseline treatment and/or addition of adjunctive treatment with "ON-extenders") have failed. Current treatment approaches combine "ON-extenders" with increasing levodopa dosing and/or frequency to treat OFF episodes. Yet, OFF episodes often persist, with a substantial amount of daily OFF time. OFF episode treatment is hindered by variable gastrointestinal (GI) absorption of oral levodopa, reflecting GI dysmotility and protein competition. Novel "on-demand" treatments bypass the gut and can improve OFF symptoms more rapidly and reliably than oral levodopa. With the emergence of novel "on-demand" treatments, we conclude that a shift in treatment paradigm to the earlier, complementary use of these medications be considered.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.