VYALEV, a combination of foscarbidopa and foslevodopa, provides continuous subcutaneous delivery of levodopa to manage motor fluctuations in advanced Parkinson's disease by ensuring more stable plasma levodopa concentrations.

Mechanism of Action and Clinical Benefits in Advanced Parkinson's Disease

VYALEV is indicated for treating motor fluctuations in adults with advanced Parkinson's disease. It combines foslevodopa, a prodrug of levodopa (an aromatic amino acid), with foscarbidopa, an aromatic amino acid decarboxylation inhibitor. Upon subcutaneous administration, foslevodopa is converted to levodopa, which is then transported to the brain and converted to dopamine, thereby compensating for the dopamine deficiency characteristic of Parkinson's disease. Foscarbidopa inhibits the peripheral decarboxylation of levodopa, increasing the amount of levodopa that crosses the blood-brain barrier and reducing peripheral side effects. Continuous subcutaneous infusion aims to maintain more stable plasma levodopa levels, leading to a reduction in "off" time and improved motor control. The efficacy in treating motor fluctuations was demonstrated in clinical studies (Study 1 mentioned, details not fully provided here but implied efficacy).