Istradefylline Brand Name– NOURIANZ
What is Istradefylline
Istradefylline is a xanthine derivative and an oral adenosine A2A receptor antagonist.
Istradefylline is approved for use as an adjuvant to levodopa-carbidopa therapy in adult patients with Parkinson’s disease (PD) experiencing ‘off’ episodes.
The efficacy of istradefylline was established in 4 placebo-controlled, randomized trials. In these trials, patients continued levodopa treatment with or without concomitant PD medications, including dopamine agonists, COMT inhibitors, MAO-B inhibitors, anticholinergics, and/or amantadine, provided these medications were stable.
In all trials, istradefylline significantly improved daily awake “off” time relative to placebo.
Decreases from baseline in the mean percentage of awake “off” hours were observed during treatment with istradefylline 20 mg/day (-4.57%, p = 0.025) and istradefylline 40 mg/day (-6.78%, p = 0.007).
Awake “off” hours were reduced from baseline, with mean differences of -0.65 hours (p = 0.028) and -0.76 hours (p = 0.006) for istradefylline 20 mg daily regimens and -0.92 hours (p = 0.002) and -0.74 (p = 0.008) for istradefylline 40 mg daily regimens.
Patients treated with istradefylline experienced additional increases from baseline in “on” time without troublesome dyskinesia compared to patients treated with placebo.
There is a potential for the drug to cause or exacerbate hallucinations or psychosis.
Istradefylline was approved by the FDA in August 2019
Indications
- Parkinson’s disease
For use as an add-on treatment to levodopa and carbidopa in adult patients with Parkinson’s disease experiencing “off” episodes
Side Effects
- agitation
- confusion
- constipation
- delirium
- diarrhea
- dizziness
- dyskinesia
- hallucinations
- impulse control symptoms
- infection
- insomnia
- libido increase
- mania
- nausea
- paranoia
- psychosis
- rash
Monitoring Parameters
- LFTs
- neurologic function
Contraindications
- behavioral changes
- breast-feeding
- children
- contraception requirements
- dyskinesia
- geriatric
- hepatic disease
- impulse control symptoms
- infants
- pregnancy
- psychosis
- reproductive risk
- tobacco smoking
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