Madopar HBS in the long-term treatment of parkinsonian patients with fluctuations in disability.

Clinical response to a new galenic formulation of levodopa plus benserazide, Madopar HBS (hydrodynamically balanced system), was studied in 20 parkinsonian patients presenting fluctuations in disability. The follow-up period was 9 months. In patients with end-of-dose type fluctuations in disability, a significantly better control of the fluctuations was obtained with Madopar HBS as compared to standard Madopar treatment. It was possible to reduce the frequency of daily dose intake, but the daily dose needed was higher (40-60%). Especially in severely disabled patients the therapeutic response to the first morning dose of Madopar HBS appeared too slowly, and therefore a combination with standard Madopar was necessary in 4 patients after 1 month treatment and in 14 patients after 9 months treatment. The therapeutic efficacy maintained the whole follow-up period, although there was some decline during the second half of the treatment year. Madopar HBS did not have any effect on randomly occurring fluctuations. Thus, the long-term follow-up results of the present study indicate that Madopar HBS is effective in producing a prolonged and stable clinical response in parkinsonian patients with end-of-dose type fluctuations in disability.