Istradefylline: First Global Approval

@article{Dungo2013IstradefyllineFG,
  title={Istradefylline: First Global Approval},
  author={Rosselle T. Dungo and Emma Deeks},
  journal={Drugs},
  year={2013},
  volume={73},
  pages={875-882}
}
Kyowa Hakko Kirin is developing istradefylline, a selective adenosine A2A receptor antagonist, for the once-daily oral treatment of Parkinson’s disease (PD). Adenosine A2A receptors are considered to be present particularly in the basal ganglia of the brain; the degeneration or abnormality observed in PD is believed to occur in the basal ganglia, which is recognized to play a significant role in motor control. Commercially available dopamine replacement therapies effectively treat the early… 
The belated US FDA approval of the adenosine A2A receptor antagonist istradefylline for treatment of Parkinson’s disease
TLDR
Istradefylline is the first non-dopaminergic drug approved by FDA for PD in the last two decades and paves the way to foster entirely novel therapeutic opportunities for adenosine A2A receptor antagonists, such as neuroprotection or reversal of mood and cognitive deficits in PD and other neuropsychiatric diseases.
The efficacy of oral adenosine A2A antagonist istradefylline for the treatment of moderate to severe Parkinson’s disease
The moderate and severe stages of Parkinson’s disease (PD) are marked by motor and non-motor complications that still remain difficult to control with the currently available therapy. Adenosine A2A
Adenosine A2A Receptor Antagonists in Drug Development
TLDR
Dual- and multi-target drugs combining A2A antagonism with A1 antagonism, MAO-B inhibition, dopamine receptor activation and/or NMDA receptor blockade may be advantageous for the treatment of PD and perhaps also for other brain diseases.
Adenosine A2A Receptor Antagonists in Parkinson’s Disease: Progress in Clinical Trials from the Newly Approved Istradefylline to Drugs in Early Development and Those Already Discontinued
  • A. Pinna
  • Biology, Psychology
    CNS Drugs
  • 2014
TLDR
Pharmacological and clinical data available on istradefylline, tozadenant, PBF-509, ST1535, ST4206, V81444, preladenant and vipadenant are summarized, suggesting that A2A antagonists might also be efficacious as monotherapy in patients at an early stage of PD.
Two new adenosine receptor antagonists for the treatment of Parkinson's disease: istradefylline versus tozadenant
TLDR
Both drugs show promising efficacy for the reduction of OFF time in levodopa-treated Parkinson's disease patients, but further research is needed in order to obtain definitive conclusions.
Istradefylline to Treat Patients with Parkinson’s Disease Experiencing “Off” Episodes: A Comprehensive Review
TLDR
Istradefylline, a novel adenosine A2A receptor antagonist, is indicated as a treatment addition to levodopa/carbidopa in patients experiencing “off episodes” of Parkinson’s disease.
Efficacy of Adenosine A2A Receptor Antagonist Istradefylline as Augmentation for Parkinson’s Disease: A Meta-analysis of Randomized Controlled Trials
TLDR
Istradefylline could be an efficacy and safety augmentation drug added on to levodopa or other existing anti-Parkinsonian therapies, limited by the number of studies, future large-scale studies are needed to verify these results.
Emerging Nondopaminergic Medications for Parkinson’s Disease: Focusing on A2A Receptor Antagonists and GLP1 Receptor Agonists
TLDR
Findings on the usefulness of A2AR antagonists and GLP1R agonists in PD management are summarized and the molecular mechanisms of these medications and their interactions with other neurotransmitter receptors are explained.
Adenosine A2A receptor antagonist istradefylline 20 versus 40 mg/day as augmentation for Parkinson’s disease: a meta-analysis
TLDR
Results indicate that istradefylline 40 mg/day as augmentation shows potential promise on clinical applicability, and is worthy of further study.
Xanthine derivatives as agents affecting non-dopaminergic neuroprotection in Parkinson`s disease.
TLDR
The current review summarizes frequently suspected non-dopaminergic neuroprotective mechanisms and the possible beneficial effects of the xanthine derivatives in PD, along with some synthetic approaches to produce perspective xAnthine derivatives as non-Dopamin allergic agents in PD treatment.
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