Not Your Grandmother’s Dopamine: PMD Alliance Releases On-Demand CME Topics in Advanced Therapeutics in Movement-Related Disorders

Fernando Pagan, MD

It’s been 200 years since James Parkinson described what we now call Parkinson disease in his seminal “Shaking Palsy” essay. Since then, a lot has happened in our understanding of Parkinson’s and other movement disorders. But according to Fernando Pagan, MD, director, Movement Disorders Program, and medical director, MedStar Georgetown National Parkinson Foundation Center of Excellence, too many physicians have been talking about and prescribing the same treatments for the past twenty years. “On a daily basis, we see patients with Parkinson disease—they’ve been diagnosed for 10, 15 years—and they’ve only been offered carbidopa/levodopa—1 treatment—as their only option,” Pagan said.

The cultivation of levodopa, a precursor for dopamine that reduces motor fluctuations in Parkinson’s patients, was revolutionary when it was developed for oral use in the late 1960s. But in the decades since, clinical research has offered us multiple innovative options: new classes of drugs and updated formulations that better support patient quality of life. Pagan believes it is each healthcare provider’s responsibility to provide their patients with forward-thinking treatments and education and to lift movement disorder care out of the 1970s and into the 21st century.

“We need to give healthcare providers a glimpse of the future,” Pagan insisted. We need to amplify advanced therapeutics and show them what’s possible because there remains a gap in physician knowledge and understanding. We need clinician education. This is why Pagan and his colleague Yasar Torres-Yaghi, MD, a board-certified movement disorder neurologist at MedStar Georgetown University Hospital, have developed continuing medical education (CME) topics for advanced therapeutics in movement disorders, which are being released by Parkinson & Movement Disorder Alliance (PMD Alliance) in partnership with MedStar Georgetown University Hospital, beginning October 22, 2021. They are a sneak preview of PMD Alliance’s Advanced Therapeutics in Movement Related Disorders Congress, taking place in May 2022.

Yasar Torres-Yaghi, MD

While research supporting new advanced therapies in treating Parkinson disease and related disorders exists, most of these clinical research studies are never seen by providers, and, overwhelmingly, providers are not effectively using the latest interventions. The gap in understanding clinical research is so profound that as one of Pagan’s movement disorder colleagues puts it, “Nothing exists that allows providers the ability to develop algorithms to better meet their patients’ needs. There is simply nothing that currently allows for that kind of integration between studies and real-life patient care.” In fact, the movement disorders clinical guidelines last published in 2005 have been retired. This is why the latest education from experts like Pagan and Torres-Yaghi is needed now more than ever.

Equipping healthcare providers with the latest clinical data and, most importantly, how to effectively translate that data into daily practice, matters for the people living with Parkinson disease every day and their families. Pagan cited contemporary studies that make it clear that in early PD: “If you do nothing, you can be sure that Parkinson disease is only going to get worse over time.” In other words, treatment—and not just the oral levodopa first offered 50 years ago—decreases patient motor disability while increasing quality of life. “Patients who were treated with a monotherapy,” compared with patients who received no treatment at all, have been shown in clinical studies to have a “better PDQ [Parkinson Disease Quality of Life] score,” Pagan said. As Parkinson disease progresses, symptoms become more burdensome, making it critical for providers to learn the best ways to identify and treat these symptoms through access to all available treatment options.

As Pagan shares in 1 CME topic called, “Not Your Grandmother’s Dopamine,” we now have clinical data that supports the use of the most innovative science like “on-extenders,” drugs that can be used in conjunction with levodopa to keep levodopa around longer, crossing the blood-brain barrier into the central nervous system, thereby increasing dopamine for longer periods of time. The outcome? Less OFF time and a higher quality of life. We also have clinical research exploring carbidopa/levodopa infusions, inhaled levodopa, and other subcutaneous variations.

While levodopa, which increases dopamine, has been the gold standard in Parkinson disease care, we’re learning that the disease is more than just a dopaminergic loss—there are other neurotransmitters involved that affect nonmotor symptoms, as well, and healthcare providers need to have the research to support patients on all these levels.

“We’re learning how to better treat patients from clinical trials,” Pagan said. “To me, this is exciting...it will be an exciting decade ahead and we’ll continue to see improvements.” But, he insists, bringing these improvements to patients is “up to us” as healthcare providers. With the right education, providers can lead the way in offering the highest quality care because, at the end of the day, there is a person on the other end of every treatment. Any advancements must center them.

To learn more about the on-demand CME topics or register for the live panel discussions on October 23 + 24th, visit the course page here:

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About Parkinson & Movement Disorder Alliance (PMD Alliance)

Parkinson & Movement Disorder Alliance is an independent, national nonprofit dedicated to providing opportunities for people to learn, live life more fully and spark meaningful connections around them. PMD Alliance serves people across the United States and is not affiliated with any medical practice or institution. PMD Alliance is committed to keeping our community safe and healthy. Visit www.PMDAlliance.org to learn more.

About MedStar Georgetown University Hospital

MedStar Health, in partnership with Georgetown University, is an organization dedicated to advancing health through learning and applying new knowledge while training the next generation of physicians and providing ongoing education and professional development. Committed to the health and wellness of the communities they serve, they strive to make world-class healthcare accessible and convenient while living out the SPIRIT of their values: Service, Patient-First, Integrity, Respect, Innovation, and Teamwork. While science is getting better, MedStar uses the best of their minds and hearts, not forgetting the importance of how they simply treat people.