Cwm Taf Morgannwg University Health Board doctor first in Wales to offer new Parkinson's treatment

Dr James Bolt, a consultant specialising in movement disorders at Cwm Taf Morgannwg UHB, has become the first doctor in Wales to offer Produodopa a medication to help treat patients with advanced Parkinson’s disease.

Parkinson’s is a progressive neurological disease, which involves a decline in dopamine levels. Dopamine is produced mainly in the brain and it helps with movement, memory, mood and control of organ functions like the gut. Patients with Parkinson’s disease have lower levels of Dopamine and present with symptoms including tremor, shuffling gait, stiffness of limbs, and mask like facial expression. However, they may have had many other features of the disease before they present with these symptoms (such sleep disturbances or problems with their bowels).

Traditionally, Parkinson’s disease has been treated with oral dopamine. However, the dose has to be increased as their body produces less dopamine. Large doses of dopamine given orally can cause issues with other movements (called dyskinesias) which can be difficult for the patient. As we age our gut does slow down, but in those with Parkinson’s Disease this is more marked. The tablets containing dopamine will pass through the gut, but much more erratically. The patient may move better on one day, but less so on another. We know from studies that only around 10% of the dopamine makes it to the brain. It is also important that the oral medication is given on time which can be difficult when patients have to take it a number of times a day. Therefore, it is important to look for alternative ways to help treat their symptoms.

Produodopa is a medication for advanced Parkinson’s Disease that is administered via a needle under the skin using a special pump. The pump delivers a small amount of the medication each hour which is gradually absorbed into the bloodstream. The pump is easy to programme and to use. It works 24 hours a day, meaning that the patient has a more consistent level of dopamine in their body throughout both the day and night.

Produodopa simplifies treatment for patients with advanced Parkinsons disease. It helps not only their motor symptoms (tremor, slowness, stiffness and dyskinesias), but has also been effective in improving their non-motor symptoms (sleep; bowel function, mood etc.). Overall. It has ben shown in initial trials to improve the patients’ quality of life.

Dr Bolt is based at the Royal Glamorgan Hospital in Cwm Taf Morgannwg University Health Board and has been working with Mr Kelland, a 66-year-old patient who has experienced tremors and been on medication since he was 18. Since Mr Kelland started using the Produodopa treatment, he has been less stiff, is more relaxed with sleep, and his tremor is less noticeable.

Dr Bolt said: “We have known for a long time that eventually the oral medication for patients with Parkinson’s disease gradually becomes less effective. We have had a number of treatments that are delivered by a wearable pump. However, none of them have been licensed to give medication over a whole day. Some patients may decide to have more invasive techniques, though this is not for everyone. Produodopa is a lightweight, wearable pump that offers a further option for suitable patients with advanced Parkinson’s disease. The results from trials around the world have been encouraging. I am thrilled that we are the first health board in Wales to provide this therapy for Mr Kelland. I am also delighted at his response to the treatment.”

Mr Kelland said: “Since being on Produodopa, I find that I sleep much better, and I have much more energy. I have more ‘Get up and go’ in general. I am enjoying life more and haven’t felt like this in years. It is an added bonus to not have to ‘clock watch’ in order to have to take medication five times per day. I was on 30 tablets per day and I injected myself with Dacepton (Apo-morphine) up to three times per day. Now I take 4 tablets per day, none of which are for my Parkinson’s Disease and I do not have to inject myself anymore. The fact that I sleep so well has improved my life greatly. The pump is easy to use, and I am delighted with the changes that it has made to my life.”

26/06/2024