NHS rolls out ‘wearable’ 24-hour infusion for advanced Parkinson’s

Hundreds of NHS patients with advanced Parkinson’s disease are set to benefit from a portable drug infusion that is gradually released around-the-clock to help better control their symptoms.

The treatment, called foslevodopa–foscarbidopa, will now offer an additional option for certain patients experiencing movement-related symptoms and whose condition is no longer responding to their oral medicines. The easy-to-use infusion is delivered through a cannula under the skin and controlled by a small automatic pump worn 24 hours a day to help steadily manage patients’ symptoms with fewer side effects.

It works by releasing a combination of medications into the body, with the drug foslevodopa being turned into the chemical dopamine, which can better transmit messages between the parts of the brain and nerves that control movement.

The new treatment option is being rolled out on the NHS in England over the coming weeks (from 27 February) and it is expected that nearly 1,000 patients will be eligible across the country. Many Parkinson’s patients currently take large numbers of tablets to control their symptoms – sometimes more than 20 a day – which can be difficult to maintain. People taking medicine this way often report that the peak of their whole day is in the morning and despite taking more tablets they go ‘downhill’ throughout the day.

It can also be a challenge for patients taking these pills to balance symptom control with side-effects, with some patients including impulse control disorders and excessive movement. Tablets can also lose their effects in the middle of the night, meaning patients can wake up with symptoms and may not be able to get out of bed to go the toilet without risking a fall.

However, by infusing this new drug formula throughout the day and overnight, symptoms can be more steadily managed – with patients also having the option to manually give themselves a boost in dose at any point during the day if needed.

James Palmer, NHS England’s Medical Director for Specialised Services and a Consultant Neurosurgeon, said: “This is great news for hundreds of patients who are living with an often difficult and debilitating condition.

“This important therapy will now offer a vital new option on the NHS for those who aren’t suitable for other treatments such as deep brain stimulation, and we hope it will help nearly a thousand patients to manage their symptoms more effectively and go about their day with a better quality of life.”

Since 2015, NHS England has offered a similar but more invasive treatment where the drugs needed to be delivered into the gut by a permanently placed feeding tube. The new device being rolled-out across the country is small and completely portable, with the infusions taking place under the skin. The easy to fit and remove drug vial normally needs to be changed once a day and the cannula is changed every three days, which can be done at home by patients or their carers.

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