How new Parkinson's disease treatment for patients works

It follows the news that hundreds of NHS patients with advanced Parkinson’s disease are now set to benefit from a portable drug infusion, which is gradually released around-the-clock to help better control their symptoms.

The treatment, called foslevodopa–foscarbidopa, will now offer an additional option for certain patients experiencing movement-related symptoms, and whose condition is no longer responding to their oral medicines.

The infusion is delivered through a cannula under the skin and controlled by a small automatic pump worn 24 hours a day, to help steadily manage patients’ symptoms with fewer side effects.

It works by releasing a combination of medications into the body, with the drug foslevodopa being turned into the chemical dopamine, which can better transmit messages between the parts of the brain and nerves that control movement.

The new treatment option is now being rolled out nationally over the coming weeks, from February 27, it is expected that nearly 1,000 patients will be eligible across the country.

Two men from Cornwall were among those who took part in clinical trials to determine the treatment was safe and effective.

John Whipps, aged 70, from Looe, said: “It’s absolutely wonderful that more people can get this drug now. Compared to the previous treatments it really is like chalk and cheese.

“Before this, I was on nearly 20 tablets a day just for my Parkinson’s symptom control, and then all the other tablets on top of that. And I would frequently wake in the middle of the night with internal tremors and take more tablets, but this pump just keeps running through the night.

“I couldn’t plan to do anything, as you don’t know if you’re going to have an off day and need to stay at home.

“So this pump has made life much more plan-able. It’s just one pump change a day you need to factor in, compared to the constant regime of tablets at different times a day.”

Advanced Parkinson's disease patients will no longer have to take large numbers of tablets every day thanks to the new pump (Image: PA)

Many Parkinson’s patients currently take large numbers of tablets to control their symptoms – sometimes more than 20 a day – which can be difficult to maintain.

People taking medicine this way often report that the peak of their whole day is in the morning and despite taking more tablets they go ‘downhill’ throughout the day.

Tablets can also lose their effects in the middle of the night, meaning patients can wake up with symptoms and may not be able to get out of bed to go the toilet without risking a fall.

However, by infusing this new drug formula throughout the day and overnight, symptoms can be more steadily managed – with patients also having the option to manually give themselves a boost in dose at any point during the day if needed.

Phil, aged 52, also from Cornwall, described how before switching to the pump he would have to take 25 tablets, which would result in him feeling 'on' and 'off' as the medication fluctuated throughout the day, with his symptoms especially bad at night.

He explained: “With Parkinson’s, some people say you’re like a marathon runner in the morning, by lunchtime it feels like you’re pushing a pram, and then at teatime it’s as if you’re in a wheelchair.

“At night, I was normally not able to turn over in bed, or get up for the toilet, and if I did manage it, I was at risk of falls.

“Whilst wearing the pump, it delivered the drug whilst I was sleeping, enabling me to turn over at night, and get up for the toilet which made a huge difference at night. As a result, I slept much better.

“The pump would run continuously. I put the vial in at 7am, and the pump delivered the drug over a long period, providing a good flat line of drug delivery during the day and then during the night. I could also boost it for an extra blast if needed.”

Parkinson’s is a condition in which parts of the brain become progressively damaged over many years and it affects around 128,000 people in England.

Since 2015, NHS England has offered a similar but more invasive treatment where the drugs needed to be delivered into the gut by a permanently placed feeding tube.

The new device being rolled-out across the country is small and completely portable, with the infusions taking place under the skin. drug vial, described as “easy to fit and remove,” normally needs to be changed once a day and the cannula is changed every three days, which can be done at home by patients or their carers.

Laura Cockram, head of campaigns at Parkinson's UK, said: "There are very few advanced treatments for the condition, so we are delighted another one is available. The infusion means people will be able to better manage their symptoms and could potentially have a big impact on families' lives.

"It won't be suitable for everybody though, and people with Parkinson's should speak to their consultant or Parkinson's nurse to see whether it's an option for them.”