Pergolide was a useful dopamine agonist monotherapy and as part of levodopa-sparing regimens before being withdrawn from the market due to fibrosis concerns related to its 5-HT2B agonistic character. Stocchi et al (Brain (2002), 125, 2058-2066) demonstrated that patients receiving lisuride infusions experienced a significant reduction in both motor fluctuations and dyskinesia over the 4-year study duration when compared to patients on standard dopaminergic therapies. In addition, the mean UPDRS scores remained the same for the lisuride-levodopa patients but deteriorated in patients on levodopa only. However, due to its short half-life and 5-HT2B agonistic character, lisuride was not a suitable replacement for pergolide.
XC130-A10H is being developed as an orally administered partial dopamine agonist for the treatment of Parkinson’s disease with the potential to provide therapy similar to the ergot alkaloid dopamine agonists. XC130-A10H is engineered to delay the commencement of levodopa administration, lower the levodopa dose for late stage patients, and avoid undesirable side effects common to the existing dopamine agonist therapies.