The Sinemet, the flagship treatment for the disease, is expected to remain unsolved until March 2019.
It is a medicine of "great therapeutic interest", according to the provisions of the decree adopted in 2016 to avoid the risk of a deficit, which now falls outside the range. The Sinemet, a flagship treatment for the treatment of Parkinson's disease, has not been available since the end of August at the 250 mg dose and the two other forms (100 mg and 200 mg extended release) will soon not be administered to patients with the Parkinson's disease. pharmacies, announced on 19 September the National Agency for Medicines Safety (ANSM). According to the MSD laboratory, which calls for "production problems", a supplement is not expected before March 2019.
The prospect of a stock-out increases the indignation of the patient associations. "For the second consecutive year and this time for a particularly long period, patients and their relatives are in a situation of insecurity, which is extremely stressful," says Florence Delamoye, director of the France Parkinson association.
According to the ANSM, 45,000 patients are being treated with Sinemet, out of 200,000 people suffering from Parkinson's disease in France. The treatment, based on Levodopa, compensates for the deficiency of dopamine in the brain that characterizes the disease. It greatly improves the symptoms: slowness and stiffness that lead to movement problems or problems with walking, trembling. "All patients will have to take a Levodopa-based medication at one time or another of their disease," says Professor Philippe Damier, a neurologist at the University Hospital of Nantes. Fifty years after his arrival in the care offer, it is still the basic treatment. "
The scenario of a shortage causes the more doctors to worry about the fact that Levodopa weaning can be dangerous. "A sudden stop can lead to potentially serious complications, even death," warns Professor Damier. In a note published on its website, the ANSM advises patients to consult their physician to find a replacement therapy. Neurologists can theoretically postpone their recipe on generic Sinemet, but the Teva laboratory, which produces one, has already warned that it can not handle demand alone.
Alternative solution, Modopar, a drug that combines levodopa with another molecule, can be proposed. "This change can only occur after a dose adjustment, and only if the patient has no history of severe intolerance," Dr. Philippe Vella, director of medicine in neurology at the ANSM. The Roche Laboratory, which produces the Modopar, has undertaken to produce it in sufficient quantities to cover the needs of patients at least until December.
The association France Parkinson fears, however, that the change of molecule will destabilize patients who are already weakened by a disease that can not be cured, but whose weakening symptoms can be alleviated by treatments.