Nourianz (istradefylline; Kyowa Kirin) is now available as an adjunctive treatment to levodopa/carbidopa in adult patients with Parkinson disease (PD) experiencing “off” episodes.

The approval of Nourianz, an adenosine A2A receptor antagonist, was based on results from 4 randomized, placebo-controlled clinical trials involving a total of 1143 PD patients who were taking a stable dose of levodopa/carbidopa with or without other PD medications. Results from all 4 studies showed a statistically significant decrease from baseline in daily “off” time in patients treated with Nourianz compared with placebo.

With regard to safety, the most common treatment-emergent adverse reactions reported were dyskinesia, dizziness, constipation, nausea, hallucination, and insomnia. 

“In my clinical practice, I see patients who experience the troublesome effects of Parkinson’s disease and ‘off’ episodes that interfere with activities of daily living,” said Peter A. LeWitt, MD, Professor of Neurology, Wayne State University School of Medicine and Director, Parkinson’s Disease and Movement Disorders Program, Henry Ford Hospital. “Nourianz represents an important milestone and provides US patients and their caregivers with a nondopaminergic, once-a-day oral treatment option to significantly decrease the amount of ‘off’ time.”

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Nourianz is supplied in 20 and 40mg tablet strengths. Dosage adjustments are recommended in patients with hepatic impairment, those taking strong CYP43A4 inhibitors, as well as tobacco smokers.  

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