By Jeff Hansen -- The Birmingham News
BIRMINGHAM - Before starting a new treatment for advanced Parkinson's disease, Dr. Mac Stinson had daily severe muscle spasms in his hands, feet and the back of his neck.
The neck spasms would pull his face up toward the sky, and Stinson's wife wasn't strong enough to pull his head out of the cramping.
But a new drug delivery system -- being tested at the University of Alabama at Birmingham and other sites -- immediately made the spasms less severe, Stinson said.
"I've had maybe 10 in the year-and-a-half I've been on the pump," he said.
UAB's Dr. David Standaert and colleagues presented four posters about the ongoing drug delivery trials last week at the Movement Disorder Society meeting. "This is a pretty exciting new treatment," said Standaert, a professor of neurology and director of UAB's Center for Neurodegeneration and Experimental Therapeutics.
Parkinson's patients who are taking oral medication for their disorder often begin -- after a period of time -- to experience a re-emergence of symptoms that cause loss of mobility.
Patients call this "off" time, as opposed to the "on" time when they feel good and symptoms are well-managed. The delivery system being tested now is a pump that sends medication continuously into the small intestine during waking hours. The breakthrough is a gel that protects the drug to prevent rapid breakdown normally caused by contact with water.
Standaert and colleagues reported on advanced Parkinson's patients who had completed 12 weeks of this 16-hour-a-day continuous treatment. The average patient went from spending about half of his or her waking hours "off" to having about three hours a day "off" and 12 hours a day "on."
"It's a huge change," said Standaert.
Standaert said the patients also reported a "very impressive improvement in the quality of life," which is a difficult thing to achieve in Parkinson's patients.
Stinson, a 49-year-old physician who first showed symptoms about 10 years ago, said he's been generally pleased with the pump.
"I feel better than I did," he said. "In the 10 years I've had this, it's the first time I can say I feel better than I did the year before."
While the pump delivery is not a magic bullet, Stinson is again playing some guitar -- classic rock, country and western -- and singing praise music at church.
He went to the Auburn championship game in Arizona with his wife, an avid fan, and last June they took a seven-day cruise to Alaska from Seattle.
The intestinal gel treatment is being developed by the health care company Abbott. Though it uses drugs that have treated Parkinson's patients in oral medications for more than 40 years, the gel protection that allows pump delivery means a steady level of the drugs in the bloodstream throughout the day -- avoiding the spikes that appear to cause problems.
Standaert said the system has turned around patients who are most difficult to treat.
"These are people who have exhausted all available remedies," he said.