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      • Identifying advanced Parkinson's disease (aPD)

      About aPD
      Identifying aPD
      Manage PD
      DAT Selection

      Recognising advanced PD is key1

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      To date, there is no clear consensus on how to define “advanced” PD.1

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      Difficulty in recognising advanced PD may lead to delayed referrals to movement disorder specialists and therefore delayed access to appropriate treatment.1,2

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      Identifying the most appropriate management approach for patients in the advancing stage of PD is essential for providing improved health-related QoL.1

      Why does predictability of response to oral levodopa regimens decline
      as PD progresses?

      The therapeutic window of oral levodopa narrows as disease progresses3,4

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      Within 5 years, half of patients with advanced PD that take oral levodopa experience a narrowing therapeutic window that can make symptom control difficult5

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      A narrow therapeutic window makes it more difficult to control symptoms without triggering treatment-related dyskinesia5

      Infographic gastric emptying

      Adapted from Olanow CW et al. 20063 and Varanese S et al. 2011.4 Schematic representation of levodopa in progressive stages of PD.
      Does not necessarily correlate to dose clinical effect.

      Gastric emptying and intestinal absorption become erratic as PD progresses4

      Gastric Emptying Infographic

      Adapted from Varanese et al. 2010.4

      The 3 criteria identified by the Delphi expert consensus panel

      The Delphi expert consensus panel of 17 movement disorder specialists identified the 3 criteria (5-2-1) as being key indicators of advanced PD.6 Australian consensus recommendations suggest that patients who are on 4 or more doses of levodopa daily may be referred to a movement disorder specialist for consideration of device-aided therapy.2

      The 5-2-1 criteria: Key indicators about your patients’ symptom control1,6

      5-2-1 criteria infographic

      The 3 criteria identified by the Delphi expert consensus panel

      MANAGE-PD allows you to:

      Identify patients inadequately controlled on oral medications.

      Determine which patients with aPD may be adequately controlled on their current treatment regimen or may require changes to their treatment regimen (including evaluation for device-aided therapy).

      Start using MANAGE-PD
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      Contact a representative
      Contact a representative

      Abbreviation: PD, Parkinson’s disease; QoL, quality of life.
      References: 1. Antonini A et al. Curr Med Res Opin 2018;34(12):2063–2073. 2. Williams DR et al. Intern Med 2017;47(10):1107–1113. 3. Olanow CW et al. Pract Neurol 2006;2(7):382–392. 4. Varanese S et al. Parkinsons Dis 2010; doi: 10.4061/2010/480260. 5. Nyholm D. Parkinsonism Relat Disord 2007;13(suppl):S13–S17. 6. Santos- García D et al. Parkinsons Dis 2020;2020:7537924.

      AU-NEUP-230058. June 2024.