Pumped Up about Promising new Parkinson’s Pump

parkinson-disease60Parkinson’s disease, as many of our readers know is a chronic, progressive neurological disease that causes sufferers to lose control of body movements, resulting in tremors, muscle stiffness, loss of balance and a host of other problems. Currently, there is no cure for Parkinson’s disease and treatment options are limited. Therapy is directed at treating the symptoms that are most bothersome and for this reason, there is no standard or “best” treatment for that applies to every patient.

Treatment approaches include medications and surgery (deep brain stimulation) as well as general lifestyle modifications (rest and exercise), physical, occupational and speech therapy.

levodopaAmong the drug-related therapies, levodopa is considered one of the most effective for relieving the symptoms of Parkinson’s disease. It helps reduce tremor, stiffness, and slowness and helps improve muscle control, balance, and walking. Levodopa does not slow the disease process, but it improves muscle movement and delays severe disability. So far, levodopa, which had been used to treat Parkinson’s since the 1970’s, has only been available in pill form.

But a new Cleveland Clinic study finds that using a pump to administer a gel form of levodopa directly into the small intestine is much more effective.

Neurologist Hubert Fernandez, MD, who led the study, says, “The levodopa pump decreased or improved what we call the ‘bad time’ in Parkinson’s patients by up to four hours per day.” The levodopa can control this ‘bad time’ — the tremors, muscle spasms and other movement disorders that makes it difficult for Parkinson’s patients to function on a daily basis.

parkinsons-gel-drug-pump-190x155This is an amazing finding,” says Fernandez. “We know of no other oral therapy that will improve the bad time in Parkinson’s by an average of four hours daily.”

The levodopa pump is external. It sits in a pouch under the patient’s shirt and provides a steady dose of the drug. The levodopa gel is administered directly into the small intestine, where most of the drug is absorbed. The constant dose makes the body’s movements more controlled and predictable, making it easier for people with the disease to plan and go about their day without worrying that the drug’s effects will wear off.

The biggest advantage of the levodopa is its efficacy,” Dr. Fernandez says. “We’re trying to deliver it on a continuous basis so the patients don’t need to take it every hour.” parkinsons gel pump

69-year-old Bob Van Housen has been living with Parkinson’s disease for over 12 years.  Prior to enrollment in the study he was having to take up to five levodopa pills every three hours to control his symptoms. Even then, his symptoms progressed to the point where it was hard to keep up.  “He was ‘off’ for at least seven hours,” said Van Housen’s wife, Carol. “Seven hours is a long time to not be able to function every day.”

The couple often had to cut their trips together short and limit their social outings outside of the house. Van Housen says that being part of the trial at Cleveland Clinic has been life-changing. “We can predict better how I’m going to feel and how I’m going to act and can plan trips and work around those times when I otherwise would have been problematic.”

The gel pump which is not yet available in the United States is currently under review by the Food and Drug Administration. Let’s hope it doesn’t hit any hurdles along the way, so others with Parkinson’s can avoid the roller-coaster of symptoms and enjoy the type of benefits that Bob has experienced.

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A vitamin-a-day may do more harm than good

One of the few businesses that has benefitted from the current U.S. recession has been the dietary supplements industry. While some predicted that falling disposable income would hamper sales of vitamins and supplements, the opposite actually occurred: As more people lost their jobs and ability to pay for healthcare, many turned to supplements to remain healthy and ward off expensive doctor visits and pharmaceutical drugs. 

However, the results of two studies, published last week may signal a  reverse of the fortunes of this $30 billion per year industry.

Last week researchers from the Cleveland Clinic announced that vitamin E can enhance chances of prostate cancer. A study involving more than 35,000 men found that those who took a daily dose of 400 IU of vitamin E had a 17% increased incidence of prostate cancer than men who took a placebo.

For the typical man, there appears to be no benefit in taking vitamin E and, in fact, there may be some harm,” said Dr. Eric Klein, an internationally renowned prostate cancer expert who served as the national study coordinator.

This surprising news was followed in short order by a report that dietary supplements can also increase mortality rate in older women.

The Iowa Women’s Health Study, which started in 1986, set out to determine to what degree diet and other lifestyle factors influence risk of chronic disease.

By the end of the study period in 2008, a total of 41,836 postmenopausal women were investigated – of which 15,594 had died. Multivitamins, vitamin B6, folic acid, iron, magnesium, zinc and copper were all associated with increased total mortality risk.  Supplemental iron was most strongly associated with increased mortality whereas, calcium supplements, were associated with a decreased risk.

Study leader Dr Lisa Harnack, associate professor of epidemiology at the University of Minnesota, said: “Among the elderly, use of supplements is widespread, often with the intention of attaining health benefits by preventing chronic diseases. Our study raises concerns regarding their long-term safety.”

SRxA’s Word on Health won’t be taking any chances. No more once-a-day for us!

Top 10 Medical Innovations for 2011

Yes, it’s THAT time of year again.  Frenzied last minute preparation for the holidays means shopping and shopping means lists, lists and more lists.

Here’s one more list that we thought you wouldn’t mind us sharing. It comes from The Cleveland Clinic, one of the most respected healthcare institutions in the country, who recently released its Top 10 medical innovations for 2011.  The list includes groundbreaking drugs for cancer, hepatitis and multiple sclerosis, as well as technical innovations including incision-less bariatric surgery and pill sized cameras.

To be in the running for the Top 10 list, innovations had to meet the following criteria:

  • Have significant potential for short-term clinical impact (either a major improvement in patient benefit or an improved function that enhances healthcare delivery).
  • Have a high probability of success
  • Be on the market or close to being introduced
  • Have sufficient data available to support its nomination.

So who made the list you ask?

With bated breath, a large drum roll and an annoying pause for a commercial break, here, in reverse order, dear Word on Health readers, are the winners for 2011:

10. Capsule endoscopy for diagnosis of pediatric GI disorders: A pill-sized camera that captures 50,000 high-resolution images during its painless six- to eight-hour journey through the digestive tract, proving better than x-ray at detecting small bowel ulcerations, polyps and areas of bleeding.

9. Oral disease-modifying treatment for multiple sclerosis: Before Fingolimod was approved by the FDA this year, MS drugs had to be injected or infused on a regular basis. This oral medication effectively stops T-cells from attacking the myelin sheaths that cover nerve fibers.

8. Exhaled nitric oxide (NO) breath analysis for diagnosing asthma: A new hand-held diagnostic testing device measures a patient’s level of exhaled NO, which is a biomarker for asthma. Monitoring NO levels allows doctors to more accurately tailor treatment strategies.

7. Transoral gastroplasty, or TOGA: A new experimental weight-loss option for obese patients who want to lose weight and improve their health without undergoing major surgery. This “scar-less” procedure represents a significant improvement in minimally-invasive bariatric surgery and losses approaching 40% of excess body weight can be expected within a year.

6. Telehealth monitoring for heart failure patients: Miniature implantable monitors to measure pulmonary artery pressure daily and at-home devices to monitor weight, heart rate and blood pressure of heart failure patients allow doctors to adjust medication quickly, improving patient outcomes and quality of life, while reducing re-hospitalizations.

5. Hepatitis C protease-inhibiting drugs: Two protease inhibitors drugs awaiting FDA approval for treatment of hepatitis C work by blocking a key enzyme that viruses need to copy themselves and proliferate. In clinical trials, cure rates for the protease inhibitors are higher than current hepatitis C treatments and have fewer side effects.

4. JUPITER study and statins for healthy individuals: The JUPITER (Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin) trial pointed out for the first time that many seemingly healthy people are at higher risk for heart disease than previously thought, suggesting that statins should be prescribed even to people with low LDL (bad cholesterol), if they have high C-reactive protein levels.

3. First therapeutic cancer vaccine approved by the FDA: While not a cure for prostate cancer, Sipuleucel-T is the first cancer vaccine to receive FDA approval. Prescribed to men with advanced prostate cancer, the drug coaxes their own immune systems into attacking and removing the cancer, reducing the risk of death by 24 percent compared to placebo.

2. Anti-CTLA-4 drug (ipilimumab), a targeted T-cell antibody for metastatic melanoma: The effectiveness of ipilimumab in treating melanoma confirms the role of immunotherapy as an effective treatment. In patients with advanced stage III or IV melanoma, 23% were still alive after two years compared to 14% of patients who received standard treatment.


1. New molecular imaging biomarker for early detection of Alzheimer’s disease: Currently, positive diagnosis of Alzheimer’s is only possible upon autopsy. But a radioactive molecular imaging compound called AV-45 and a PET scan can allow doctors to “see” inside patients’ brains to detect beta-amyloid plaques, the tell-tale signature of Alzheimer’s.

If the technology is important to Cleveland Clinic it should be important to you,” said Christopher Coburn, Executive Director, Innovations, at the Cleveland Clinic.

Would these have been your picks?  SRxA’s Word on Health would like to hear from you.