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ContentsMenu
 * Overview & Learning Objectives
 * Faculty & Disclosures
 * Video Chapters (7)
   * Welcome and introduction Time: 00:00
   * The impact of OFF Episodes, Including Delayed ON Time: 00:05
   * The current treatment approach to OFF Time: 00:10
   * Panel discussion: how to identify the type of OFF and select an
     intervention Time: 00:15
   * Selecting patients: Delphi Panel on the Pharmacological Approach to OFF
     Episodes in PD Time: 00:20
   * Panel discussion: how to select patients Time: 00:25
   * Conclusions and close Time: 00:30
 * References
 * Downloads

 * Leave Feedback
 * Back to Learning Zone
   

Parkinson's Disease, Movement Disorders View Time: TBC


TOUCHROUNDTABLE THE IMPACT OF DELAYED ON: TREATING OFF EPISODES IN PATIENTS WITH
PARKINSON’S DISEASE

Leading experts Stuart Isaacson MD, Yasar Torres-Yaghi MD, Rajesh Pahwa MD
discuss how to reduce the impact of delayed ON in Parkinson’s disease

DR STUART ISAACSON

Parkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, FL,
USA

CHAIR

PANELISTS:

Dr Yasar Torres-Yaghi, Dr Rajesh Pahwa
0:33










WELCOME AND INTRODUCTION

Dr Isaacson provides an overview of the changing response to levodopa over time
and the types of OFF episodes, which patients may experience.

1/7 Next Chapter

THE IMPACT OF OFF EPISODES, INCLUDING DELAYED ON

Dr Yasar Torres-Yaghi describes the incidence of OFF episodes, the relationship
between quality of life and OFF episodes, and the contribution of delayed ON to
daily OFF time based on data from various studies (including observational
studies) and surveys.

2/7 Next Chapter

THE CURRENT TREATMENT APPROACH TO OFF

Dr Pahwa outlines the goals of treating OFF, the impact of existing therapies on
OFF episodes, and a potential shift in treatment paradigm for OFF episodes.

3/7 Next Chapter

PANEL DISCUSSION: HOW TO IDENTIFY THE TYPE OF OFF AND SELECT AN INTERVENTION

The panel discusses how to identify which type of OFF episodes a patient is
experiencing and how to select an appropriate intervention.

4/7 Next Chapter

SELECTING PATIENTS: DELPHI PANEL ON THE PHARMACOLOGICAL APPROACH TO OFF EPISODES
IN PD

Dr Isaacson provides an overview of the methodology and results of a Delphi
panel to develop a consensus on when on-demand therapies should be considered
for the treatment of OFF episodes.

5/7 Next Chapter

PANEL DISCUSSION: HOW TO SELECT PATIENTS

The panel discusses how to select patients who may benefit from on-demand
therapy.

6/7 Next Chapter

CONCLUSIONS AND CLOSE

The panel conclude discussions with the key take-home messages.

7/7 Leave Feedback
 * Overview & Learning Objectives
 * Faculty & Disclosures
 * References
 * Downloads


Leave Feedback

LEARNING OBJECTIVES & OVERVIEW

OVERVIEW

The consistent beneficial effect of each levodopa dose is reduced with
Parkinson’s disease progression leading to increased frequency of cycling
between ON and OFF states.1 OFF episodes can result from delayed onset of
response to a levodopa dose (delayed ON).1 On-demand treatments can provide an
acute conversion from OFF to ON for all types of OFF episodes, and can serve as
a complementary therapy to address delayed time to ON.1–5 In this activity,
leading experts provide guidance on when to use on-demand therapy and which
patients may benefit.

LEARNING OBJECTIVES

After watching this activity, participants should be better able to:

 * Outline the impact of delayed ON in the context of the total daily OFF time
   experienced by a patient.
 * Discuss potential changes in treatment approach based on the type of OFF
   experienced by patients.
 * Identify patients who may benefit from an on-demand therapy for OFF based on
   the findings of an expert consensus panel.

FACULTY & DISCLOSURES

DR STUART ISAACSON

Parkinson's Disease and Movement Disorder Center of Boca Raton, Boca Raton, FL,
USA

Dr Isaacson is a neurologist specializing in Parkinson’s disease and movement
disorders, and Medical Director of the Parkinson’s Research and Education
Foundation. He has been involved in over 75 clinical trials and has authored or
nearly 100 journal articles, book chapters and abstracts. He has also served on
national and international committees for drug development programs and trials,
as well as for the Parkinson Study Group and the movement disorders section of
the American Academy of Neurology.

Honoraria for CME, consultant, research grants, and/or promotional speaker on
behalf of: Abbvie, Acadia, Acorda, Adamas, Addex, Affiris, Alexza, Allergan,
Amarantus, Amneal, Aptinyx, Axial, Axovant, Benevolent, Bial, Biogen, Biovie,
Britannia, Cadent, Cala, Cerecor, Cerevel, Cipla, Eli Lilly, Enterin, GE
Healthcare, Global Kinetics, Impax, Impel, Intec Pharma, Ipsen, Jazz, Kyowa
Kirin, Lundbeck, Merz, Michael J. Fox Foundation, Mitsubishi Tanabe, Neuralys,
Neurocrine, Neuroderm, Novartis, Parkinson Study Group, Pharma2B, Praxis,
Prilenia, Promentis, Revance, Roche, Sage, Sanofi, Scion, Stoparkinson,
Sunovion, Sun Pharma, Supernus, Teva, Theravance and Transposon.

DR YASAR TORRES-YAGHI

Department of Neurology, Medstar Georgetown University Hospital, Washington D.C,
USA

Dr Torres-Yaghi is an expert in movement disorders at Medstar Georgetown
University Hospital. He completed a fellowship at MedStar Georgetown University
Hospital in neuro-restoration research. Dr Torres-Yaghi is also leading a
research initiative to care for aging patients with neurodegenerative conditions
with overlapping features of both cognitive impairment and Parkinson’s disease.

Honoraria from Sunovion.

DR RAJESH PAHWA

University of Kansas Medical Center, Movement Disorders Division, Kansas City,
KS, USA

Dr Rajesh Pahwa is Professor of Neurology and Director of Parkinson Foundation
Center of Excellence at the University of Kansas Medical Center. He has
conducted more than 75 clinical trials related to Parkinson’s disease and other
movement disorders and published more than 250 peer-reviewed articles, chapters
and abstracts in leading neurology and movement disorder journals.

Consultant for Abbott, AbbVie, ACADIA, Acorda, Allevion, Amneal, Artemida,
Avion, BioVie, CalaHealth, Global Kinetics, Insightec, Jazz, Kyowa, Neurocrine,
Neuroderm, PhotoPharmics, Sage, Sunovion, Supernus, UCB and Wren. Research
support from Abbott, AbbVie, Addex, Biogen, Biohaven, Boston Scientific, EIP,
Global Kinetics, Impax, Intec, Lilly, Neuroderm, Neuraly, Parkinson’s
Foundation, Pharma 2B, Prelinia, Roche, Sage, SIS, Sun Pharma, Sunovion,
Theranexus, Theravance, and Voyager.

REFERENCES

REFERENCES

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 35. Stocchi F, Coletti C, Bonassi S, et al. Early-morning OFF and levodopa dose
     failures in patients with Parkinson's disease attending a routine clinical
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     "OFF" episodes on health-related quality of life among patients with
     Parkinson's disease in the United States. BMC Neurol. 2021;21:46.
 39. Thach A, Zichlin M, Peddle M, et al. Systematic literature review of key
     outcomes used to assess adjunctive treatments for Parkinson’s disease.
     Presented at: International Parkinson’s Disease and Movement Disorder
     Society Congress (MDS); 15–18 September, 2022; Madrid, Spain. Poster 783.

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