Pharmacokinetic drug evaluation of CVT-301 for the treatment of Parkinson's disease

Expert Opin Drug Metab Toxicol. 2018 Dec;14(12):1189-1195. doi: 10.1080/17425255.2018.1550483. Epub 2018 Dec 2.

Abstract

Levodopa (LD), in combination with a decarboxylase inhibitor, is a mainstay and the most effective therapeutic agent in the treatment of Parkinson's disease (PD). Unfortunately, during chronic treatment with this agent, ON-OFF phenomena and dyskinesia appear. Despite the many medical treatment options available, unpredictable OFF episodes can still occur and be severe and disabling. A rescue therapy that provides a rapid and predictable ON response for patients with OFF periods would be of great value for such patients. Areas covered: CVT-301 is a self-administered dry powder aerosol inhaled formulation of LD that is being developed as a self-administered treatment for OFF periods. The PK profile of CVT-301, the efficacy, and the safety highlighted in randomized clinical trials will be reviewed. Expert opinion: CVT-301 may offer several potential advantages including increased systemic bioavailability through pulmonary absorption, rapid onset of action, avoidance of first-pass drug metabolism and less plasma-level variability. List of Abbreviations: PD: Parkinson's disease; LD: Levodopa; CD: Carbidopa; AADC: aromatic L-amino acid decarboxylase; IR: immediate-release; FPD: fine particle dose; GI: gastrointestinal; PK: pharmacokinetic; CVs: coefficient of variation; UPDRS: Unified Parkinson's Disease Rating Scale; AEs: adverse events; FEV: forced expiratory volume; FVC: forced vital capacity; DLCO: diffuse lung CO ; tmax: time to maximum concentration.

Keywords: CVT-301; Levodopa; ON–OFF; Parkinson’s disease; dyskinesia; inhalable levodopa; motor fluctuations.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Aerosols
  • Antiparkinson Agents / administration & dosage*
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / pharmacokinetics
  • Biological Availability
  • Dopamine Agents / administration & dosage
  • Dopamine Agents / adverse effects
  • Dopamine Agents / pharmacokinetics
  • Humans
  • Levodopa / administration & dosage*
  • Levodopa / adverse effects
  • Levodopa / pharmacokinetics
  • Parkinson Disease / drug therapy*
  • Randomized Controlled Trials as Topic

Substances

  • Aerosols
  • Antiparkinson Agents
  • Dopamine Agents
  • Levodopa