On/off fluctuations
Wearing-off, motor fluctuations and strategies (formulation changes, rescue therapies) to smooth them.
State of the art
No update yet for On/off fluctuations. An update is a standalone state-of-the-art for the topic — what someone with Parkinson's needs to know about where this approach stands today.
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Observations on an Open‐Label Phase 1/2 Dopamine Gene Therapy Trial (OXB‐102/Axo‐Lenti‐PD) in People with Parkinson's Disease
In the six treated participants, a single intraputaminal infusion of OXB-102 was associated with roughly 40% improvement in UPDRS-III off-state motor scores and a ~20% reduction in daily levodopa dose, consistent with the goal of smoothing dopamine delivery and reducing off-time — though placebo effect cannot be excluded in this uncontrolled study. -
Patient-Calibrated Dynamical Modeling and Embedded Trend-Zone Predictive Control for Closed-Loop Deep Brain Stimulation in Parkinson's Disease
Conventional DBS with fixed parameters cannot track the moment-to-moment changes in a patient's motor state that drive on/off fluctuations. The patient-calibrated predictive controller described in this paper is aimed at keeping beta oscillations — a real-time proxy for motor state — within a therapeutic zone continuously, which would translate clinically into smoother, more consistent motor control across the day. -
Phase 3 trial of solengepras for Parkinson’s disease now fully enrolled
Solengepras targets on/off fluctuations via GPR6 blockade rather than dopamine manipulation; its Phase 2 trial showed significant reductions in daily off time and increased good on time as an add-on to levodopa, and the pivotal Phase 3 ARISE trial is now fully enrolled. -
Vyalev eases motor, nonmotor symptoms in advanced Parkinson’s
ROSSINI interim data show that 24-hour continuous subcutaneous Vyalev infusion reduced mean daily off time from ~5.2 hours to ~2.4 hours at six months in real-world advanced Parkinson's patients, supporting the clinical-trial efficacy signal in a routine-care setting.