Fortschreitende Parkinson-Krankheit

The prevalence of Parkinson’s disease is increasing steadily and with it the number of patients suffering from motor fluctuations, in whom, despite optimized oral/transdermal drug treatment, adequate symptom control is no longer possible. Typically, this correlates with reduced quality of life. For this group of patients, the therapeutic options have recently expanded, so that in addition to deep brain stimulation, jejunal levodopa preparations (levodopa–carbidopa intestinal gel [LCIG], levodopa–carbidopa–entacapone intestinal gel [LECIG]), and subcutaneous administration of apomorphine, which is also controlled by a pump, the spectrum now also includes continuous, subcutaneously administered foslevodopa/foscarbidopa as an innovative device-aided therapy. In the following article, the available device-aided therapies and their advantages and disadvantages are discussed and the novel foslevodopa/foscarbidopa formulation is examined in more detail and supported by a case study. It is crucial for the success of therapy that suitable patients are referred to the appropriate therapy option as early as possible. The ‘5-2‑1 rule of thumb’ has proven useful in clinical practice as a quick and sensitive screening tool, which can be used to reliably determine a patient’s basic suitability for device-aided therapy.