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H. pylori Eradication Improves Levodopa Absorption
Helicobacter pylori eradication and L-dopa absorption in patients with PD and motor fluctuations
Eradicating H. pylori infection improves levodopa pharmacokinetics and increases on time in patients with motor fluctuations, according to this double-blind study.
Thirty-four PD patients with motor fluctuations and H. pylori (HP) infection were randomized to receive either eradication therapy (amoxicillin, chlarithromycin, and omeprazole) or antioxidant therapy (allopurinol, “chosen for its antioxidant properties, able to heal duodenal ulcer”). Two of 19 patients in the eradication group dropped out. Of the remaining 17, 15 became HP-negative after 3 months, whereas none of the antioxidant group did.
Follow-up endoscopy revealed significantly greater improvement in gastritis and duodenitis in the eradication group as well. The eradication group had significantly higher area under the curve and plasma concentration for a single levodopa dose. Average daily on time improved with eradication treatment by over 1 hour, and worsened with antioxidant treatment.
The authors conclude, “L-dopa pharmacokinetic changes after HP eradication may represent an attractive therapeutic opportunity for those patients with fluctuating clinical response to L-dopa”.