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Abstract Details

Inhaled Levodopa (LD) as a Treatment for Parkinson’s Disease (PD) Patients in an Emergency Setting
Movement Disorders
Movement Disorders Posters (7:00 AM-5:00 PM)
079
Case studies reporting use of CVT-301 (inhaled LD) to treat PD patients with complicated OFF period symptoms presented to the emergency department (ED).
OFF periods occur in PD and can lead to ED visits and extensive workups to identify precipitating illness. Oral carbidopa/levodopa (CD/LD) has limited utility as a medication in patients with severe akinesia involving oropharyngeal muscles and impaired swallowing, and due to gastroparesis, can lead to delayed LD absorption.
n/a

Case 1: 81-year-old male with dementia attended clinic for a routine visit suffering from OFF episode with severe freezing and rigidity in all extremities, tremor, severe confusion, hyperpyrexia, drenching sweat, severe hypertension (BP205/170), sinus tachycardia (HR125), and dyspnea (RR22). Last dose of LD medication was >5 hours earlier. 15 min after CVT-301 administration, BP was 155/95, HR95, and RR18. Gait, tremor, and rigidity improved significantly, and nonmotor symptoms resolved within 10 min. Case 2: 70-year-old patient on LD/CD intestinal gel (LCIG) with altered mental status, respiratory distress, autonomic instability, and severe rigidity, BP185/110, HR120, RR25, O2 sats 90%. Source was interrupted delivery of LCIG due to tube failure. Neurology consultation found patient to be in an OFF episode. Successfully treated within 15 min with CVT-301. Vital signs stabilized and respiratory distress improved. Patient discharged within 24 hours without complication and resumed LCIG treatment after PEG tube elective replacement. Case 3: 78-year-old male, post deep brain stimulation (DBS) and on extended-release CD/LD, presented to ED in an OFF period with no response to routine CD/LD dose. Patient had accidentally turned off DBS. After resuming DBS, his severe motor symptoms continued. CVT-301 dose improved motor symptoms rapidly and he was successfully discharged.

CVT-301 administration in patients with acute OFF episodes rapidly improved their OFF symptoms, prevented an ED visit, unnecessary and costly acute workup, or hospital admission.

Authors/Disclosures
Yasar A. Torres-Yaghi, MD
PRESENTER 		Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Torres-Yaghi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amneal. Dr. Torres-Yaghi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbott. Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Torres-Yaghi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sunovion .
Shahnaz Miri, MD (Wilmer Eye Institute, Johns Hopkins University) Dr. Miri has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Lawfirm. Dr. Miri has or had stock in IATRION.Dr. Miri has received intellectual property interests from a discovery or technology relating to health care.
Steven W. Nakano, MD Dr. Nakano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyowa Kirin Group. Dr. Nakano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acadia Pharmaceuticals.
Amelia Carwin, MD (SCL Health) Dr. Carwin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia. Dr. Carwin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyowa Kirin.
Muhammad W. Anjum, MD (LSUHSC-S Department of Neurology) Dr. Anjum has nothing to disclose.
Fahd Amjad, MD (Georgetown University Hospital) Dr. Amjad has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for TEVA. Dr. Amjad has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acadia. Dr. Amjad has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merz. Dr. Amjad has received personal compensation in the range of $0-$499 for serving as a Consultant for abbvie. Dr. Amjad has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Amjad has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kyowna Kirin. Dr. Amjad has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. Dr. Amjad has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for This information is included in the consultant disclosure. The institution of Dr. Amjad has received research support from Roche.
Fernando L. Pagan, MD, FÂ鶹´«Ã½Ó³»­ (Georgetown University Hospital Dept of Neurology) Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acorda. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Adamas. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kyowa Kirin. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sunovion. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for US World Meds. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Supernus. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Adamas. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amneal. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurocrine. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Parkinsonism and related Disorders. Dr. Pagan has stock in Keiferx. The institution of Dr. Pagan has received research support from US World Meds. The institution of Dr. Pagan has received research support from Novartis.