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Hauser RA, Banisadr G, Vuong K, et al. Real-World Experience with Carbidopa-Levodopa Extended-Release Capsules (Rytary. Parkinsons Dis. 2021;2021:6638088doi: 10.1155/2021/6638088.
Hauser, R. A., Banisadr, G., Vuong, K., Freilich, D., Fisher, S., & D'Souza, R. (2021). Real-World Experience with Carbidopa-Levodopa Extended-Release Capsules (Rytary. Parkinson's disease, 20216638088. https://doi.org/10.1155/2021/6638088
Hauser, Robert A, et al. "Real-World Experience with Carbidopa-Levodopa Extended-Release Capsules (Rytary." Parkinson's disease vol. 2021 (2021): 6638088. doi: https://doi.org/10.1155/2021/6638088
Hauser RA, Banisadr G, Vuong K, Freilich D, Fisher S, D'Souza R. Real-World Experience with Carbidopa-Levodopa Extended-Release Capsules (Rytary. Parkinsons Dis. 2021 Feb 19;2021:6638088. doi: 10.1155/2021/6638088. eCollection 2021. PMID: 33688424; PMCID: PMC7914099.
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Parkinsons Dis. 2021 Feb 19;2021:6638088. doi: 10.1155/2021/6638088. eCollection 2021.

Real-World Experience with Carbidopa-Levodopa Extended-Release Capsules (Rytary.

Parkinson's disease

Robert A Hauser, Ghazal Banisadr, Kara Vuong, David Freilich, Stanley Fisher, Richard D'Souza

Affiliations

  1. University of South Florida, Tampa, FL, USA.
  2. Amneal Pharmaceuticals, Bridgewater, NJ, USA.

PMID: 33688424 PMCID: PMC7914099 DOI: 10.1155/2021/6638088

Abstract

BACKGROUND: The introduction of carbidopa-levodopa extended-release (CD-LD ER) capsules (Rytary®) did not go as smoothly as expected, largely due to difficulty around dose conversion from available immediate-release (IR) levodopa (LD) formulations. The dose conversion table in the CD-LD ER prescribing information was similar to the table used in the pivotal clinical trial and is considered by many prescribing HCPs to be less than optimal. By the end of the dose conversion period in that trial, dosing in 76% of subjects was adjusted for symptom control; roughly 60% of patients required a higher dose and about half required more frequent administration than the recommended TID dosing.

OBJECTIVE: The primary objective of our nationwide (US) survey was to determine the dose conversion strategy most commonly employed by CD-LD ER frequent prescribers. The survey also aimed to explore additional features regarding CD-LD ER use in clinical practice.

METHODS: A survey consisting of 21 multiple-choice questions was developed and administered to experts in the use of CD-LD ER, based on prescription volume.

RESULTS: Of the 394 HCPs who were invited to participate, 90 (23%) HCPs completed the survey. All respondents were aware of the dose conversion table; the largest group did not find the table to be helpful and did not use it to convert patients to CD-LD ER. The most common strategy in calculating the CD-LD ER dose was based on the total daily LD IR dose, with the majority of that group initiating dose conversion by doubling the total daily LD dose from CD-LD IR and administering CD-LD ER one less time per day.

CONCLUSION: Overall, most survey respondents agreed that a good starting point for CD-LD ER conversion could be doubling the daily LD IR dose and administering it one time less frequently. Moreover, rapid patient follow-up after initial dose conversion to allow for further dose adjustments plays a critical role in achieving success. Gaining experience over time is important for satisfactory conversion.

Copyright © 2021 Robert A. Hauser et al.

Conflict of interest statement

RAH has received fees from Amneal Pharmaceuticals for consulting work and as a speaker. GB, DF, SF, and RD are employees of Amneal Pharmaceuticals. KV is a former employee of Amneal Pharmaceuticals.

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