Objective: Istradefylline is a selective antagonist of adenosine A2A receptor and was approved first in Japan for Parkinson’s disease (PD) patients with by symptoms of wearing-off. The phase III trial showed that 20mg of orally administrated istradefylline decreased the Off-time.

Background: In some patients, istradefylline showed prominent effects, but in some patients, it showed no benefits.

Methods: We examined the differences of the characteristics between the responders and the non-responders on 2 months of 20mg / day of istradefylline in PD patients with wearing-off.

Results: Average attributes of the enrolled thirty one patients were as follows, age: 65.4 (SD 10.4) years old, disease duration: 10.4 (SD 6.1) years, daily levodopa dosage: 553.2 (SD 228.7) mg, frequency of the levodopa consumption: 4.7 (SD 1.5) times, levodopa equivalent dose: 811.2 (SD 307.5) mg. There were significant differences (p < 0.05) in sex (male/female: 5/16, 6/4), age (62.9 (SD 10.4), 70.6 (SD 8.0) years old), age at onset (51.9 (SD 12.3), 61.5 (SD 10.5) years old) and Epworth sleepiness scale (4.3 (SD 2.8), 10.6 (SD 7.5) p < 0.01) for the responders and the non-responders, respectively. There were no differences in the disease duration, On-time, Off-time, Unified Parkinson’s disease Rating scale, daily levodopa dose, levodopa equivalent dose, cumulative dose of levodopa, or coffee intake.

Conclusions: Our data suggests younger or female patients without excessive daytime sleepiness are more candidate for istradefylline therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/differences-between-responders-and-non-responders-of-istradefylline-for-the-wearing-off-in-parkinsons-disease/