Impact of istradefylline on motor and non-motor symptoms in patients with Parkinson's disease: Subanalysis of the ISTRA ADJUST PD.

Nagayama H, Kano O, Sengoku R, Yanagisawa N, Yoritaka A, Suzuki K, Nishikawa N, Mukai Y, Nomura K, Yoshida N, Seki M, Matsukawa MK, Terashi H, Kimura K, Tashiro J, Hirano S, Murakami H, Joki H, Uchiyama T, Shimura H, Ogaki K, Fukae J, Tsuboi Y, Takahashi K, Yamamoto T, Kaida K, Ihara R, Kanemaru K, Hatano T.

Clin Park Relat Disord · 2025-04-17

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IntroductionParkinson's disease (PD) presents with diverse motor and non-motor symptoms, some of which do not fully respond to dopamine replacement therapy. To clarify the effects of the adenosine A2A receptor antagonist istradefylline (IST) on PD symptoms, we conducted a subanalysis of the 37-week ISTRA ADJUST PD randomized controlled trial.MethodsPatients with PD experiencing wearing-off with levodopa at 300-400 mg/day were randomized 1:1 to receive IST or no IST (control). Levodopa doses were titrated according to clinical severity throughout the study. PD symptoms were assessed using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Parkinson's Disease Questionnaire-39 (PDQ-39).ResultsThe efficacy analyses included 105 patients (IST, n = 52; control, n = 53). Regarding MDS-UPDRS subitems in patients in the IST group, significant improvements (p p p ConclusionIST can improve motor and non-motor symptoms and quality of life suggesting that it provides more comprehensive improvement in PD symptoms than increasing the levodopa dose alone.Clinical trial registrationJapan Registry of Clinical Trials; study ID: jRCTs031180248.

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