Abstract Details

Title Real-time Levodopa Level Monitoring from Capillary Blood in Parkinson’s Disease: A Pilot Study

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-014

Objective We used disposable biosensors to measure capillary blood levodopa concentration in Parkinson’s disease (PD) after participants ingested oral carbidopa/levodopa, with the goal of correlating levodopa levels with motor symptoms.

Background Individuals with PD often have unpredictable and disabling symptom fluctuations. A crucial need exists to improve symptom management when patients develop a narrow therapeutic window, which requires better management of the levodopa doses according to the levodopa concentrations. Currently, no practical, decentralized, and rapid method exists for measuring levodopa levels. Accordingly, a crucial need exists to better understand the variable responses of PD symptoms to levodopa to improve dose adjustments, which would improve symptom management. We have developed a novel method to measure levodopa levels using capillary fingerstick blood in PD for timely and personalized medication adjustment.

Design/Methods We enrolled participants with Hoehn and Yahr (1) stages I-IV idiopathic PD taking oral carbidopa/levodopa at least 50 years old. Using MDS-UPDRS Part IV, participants were categorized depending on levodopa response as “stable” (score =0) or “fluctuators” (score > 0) (2). During the study visit, participants arrived "off” after holding levodopa for at least 12 hours, then took one dose of oral carbidopa/levodopa. Serial assessments were performed every 10 minutes for 120 minutes total: fingerstick for capillary blood levodopa levels, plasma levodopa levels, vital signs, and an abbreviated version of the MDS-UPDRS Part III for motor performance (3).

Results We collected pilot data from 11 participants with PD. Results from the capillary blood biosensor showed levodopa peak dose within 30-40 minutes; in most, the best motor symptom improvement occurred around 30-50 minutes.

Conclusions The capillary blood showed the expected levodopa pharmacokinetic curve, which corresponded with improvement in motor symptoms. We envision that this technology can eventually guide optimal, individualized therapy for PD in a manner analogous to at-home blood glucose monitoring in diabetes mellitus.

Authors/Disclosures
Katherine Longardner, MD (UCSD MEDICAL CENTER) PRESENTER	Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. An immediate family member of Dr. Longardner has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Boston Scientific. An immediate family member of Dr. Longardner has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Trisalus. An immediate family member of Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AstraZenica. An immediate family member of Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sirtex. An immediate family member of Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Society of Interventional Oncology. An immediate family member of Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for France Foundation. An immediate family member of Dr. Longardner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Varian. Dr. Longardner has received research support from NIH.
Jong-Min Moon	No disclosure on file
Hamidreza Ghodsi, MD	Dr. Ghodsi has nothing to disclose.
Chochanon Moonla (University of California San Diego (UCSD))	Chochanon Moonla has nothing to disclose.
Kuldeep Mahato (University of California- San Diego)	Kuldeep Mahato has nothing to disclose.
Irene Litvan, MD, FAAN (UC San Diego Parkinson and Other Movement Disorder Center)	Dr. Litvan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aprinoia. Dr. Litvan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Litvan has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology. Dr. Litvan has received personal compensation in the range of $50,000-$99,999 for serving as a Chief Editor with Frontiers in Neurology.
Joseph Wang (UCSD)	Joseph Wang has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for VitalTrace.

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