Name: Juvmo (tavapadon) in Parkinson's disease: Adenosine A2A receptor antagonists
Published: 2026-09-27T21:44:59-04:00

Product information and disease description Place of product in therapy Approaches to treatment Current treatment options and standard of care

Adenosine A2A receptor antagonists

4 evidence topics · 4 sources

Efficacy conclusion for istradefylline in motor fluctuations

“Istradefylline is likely efficacious to treat motor fluctuations in PD patients on (attempted) optimal oral levodopa therapy.” (opens the source at this quote in a new tab)
“The reduction in OFF‐time with istradefylline was inconsistent and of unclear clinical relevance, ranging from 12 min (in larger studies) to 114 min (in smaller studies).” (opens the source at this quote in a new tab)

Regulatory status and pooled effect of istradefylline

“The classification of istradefylline as "likely efficacious" is interesting, since the EMA issued a negative opinion in 2021,” (opens the source at this quote in a new tab)
“refusing approval for istradefylline as an add‐on treatment for motor fluctuations, considering the available evidence as inconsistent and not satisfactorily showing effectiveness to reduce ‘off’ time.” (opens the source at this quote in a new tab)
“A pooled analysis of eight phase IIb/III trials suggested that istradefylline reduces daily off‐time by only 0.38 or 0.45 hr more than placebo at 20 or 40 mg/day, respectively.” (opens the source at this quote in a new tab)

Approval of istradefylline in Japan and the United States

“Istradefylline is an adenosine A2A receptor antagonist which was shown to reduce OFF-time ranging from 12 to 114 min in several trials and has been in clinical use to treat motor fluctuations in Japan for many years and more recently (2019) also received FDA approval” (opens the source at this quote in a new tab)

Istradefylline for motor fluctuations and as monotherapy: evidence-based review conclusions

“Because of the conflicting evidence but generally positive outcomes, the efficacy conclusion is “likely efficacious,” and the implication for clinical practice is “possibly useful.”” (opens the source at this quote in a new tab)
“However, the lack of efficacy as monotherapy suggests that targeting the adenosine system alone may not be sufficient for treating PD motor symptoms.” (opens the source at this quote in a new tab)