Kern & Diana Video - Transcript

TEXT ON-SCREEN:

A PATIENT’S JOURNEY

TEXT ON-SCREEN and narrator:

This is the story of one patient, and individual experiences may vary with Duopa (carbidopa and levodopa). 

Only you and your doctor can decide if Duopa is right for you. Your doctor is your best resource for medical information.

Please watch Important Safety Information throughout and at the end of this video and see accompanying full Prescribing Information including Medication Guide, which is also available at www.rxabbvie.com.

TEXT ON-SCREEN:

Kern’s experience with advanced Parkinson’s before Duopa…

Kern, age 70

Kern:

I’m Kern Jackson and this is my wife Diana, and we’ve moved from Oklahoma. We have 4 children of our own, but one…one is married and has 6 children and farms in this area, and we decided to move and be close to them.

TEXT ON-SCREEN:

Diana, Kern’s wife

Diana:

It’s been so sweet to be 4 miles down the road.

Kern:

I went to medical school. I met Diana in my senior year. She was in her nursing school, RN, and I wouldn’t recommend it, but we got married a week before I started the internship. 

2008 or so I was diagnosed, and it’s just been a very slow evolution – worse over the past couple of years. Sometimes it’s a real struggle. I just freeze up, can’t move, get muscle spasms, and so on.

Diana:

With the ups and downs, he’ll get stuck. 

Kern voiceover:

I just have to find a place to sit down or lie down and just wait for things to get better. 

TEXT ON-SCREEN:

Jason Aldred, MD, FAAN

Northwest Neurological, PLLC

Spokane, WA

Healthcare professionals in this video have been compensated by AbbVie.

Dr Aldred:

For many years, Kern’s medications have worked well. But over time, the medication effect began to kick in and wear off and cause lots of problems.

Kern:

My big problem is 3, 4, 5 episodes of just being “off” during the day, and it takes—I take medicine every 2 hours.

TEXT ON-SCREEN:

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson’s disease. 

Dr Aldred voiceover:

But then we talked about Duopa as a treatment option. 

TEXT ON-SCREEN:

Duopa is delivered continuously into your small intestine over 16 hours a day via tubing and a portable pump.

Dr Aldred:

I thought Kern would be a good candidate for Duopa because his response to oral carbidopa/levodopa is really quite good, but it’s short-lived. So, with Duopa, we’re able to take that next step and provide continuous delivery of levodopa throughout the daytime. 

TEXT ON-SCREEN:

Do not take DUOPA if you currently take or have recently taken (within 2 weeks) a medication for depression called a non-selective monoamine oxidase (MAO) inhibitor. 

Dr Aldred:

When talking to a patient about Duopa, I discuss the possible benefits anticipated from the delivery method as well as the possible risk. 

TEXT ON-SCREEN:

Before the stoma procedure, tell your healthcare provider if you ever had a surgery or problems with your stomach.

Dr Aldred voiceover:

I also talk to them about the procedure needed to place the tubing to deliver Duopa.

TEXT ON-SCREEN:

Talk to your doctor about how to care for your stoma and regularly check for signs of infection. Symptoms of infection may include: drainage, redness, swelling, pain, or feeling of warmth around the small hole in your stomach wall (stoma).

Dr Aldred:

A small hole called a stoma is made in their stomach wall to place the tubing. They will need to care for the stoma and watch for symptoms of infection like drainage, redness, swelling, pain, or feeling of warmth around the stoma.  

Stomach and intestine problems from the procedure needed to receive Duopa can occur.

Dr Aldred:

Some of these may require surgery or be fatal.  

I instruct my patients to tell me if they experience symptoms of stomach and intestine problems such as stomach pain… 

Dr Aldred voiceover:

…constipation that doesn’t go away, nausea or vomiting, fever, and bloody or dark tarry stool.  

Kern:

So, a lot went into the decision, but it just seemed to me that I finally reached a point, I’m going to have to do something different. It’s been a steady progression and a worsening of symptoms. 

Dr Aldred:

So, you’re ready to start Duopa.

Kern:

I think so, sir. We’ve got it all set up, I believe. 

Dr Aldred:

All right. Well, the procedure date’s set. What they’ll do at that day is get you comfortable, give some medication so that you relax, and then they’ll do the procedure. And then afterwards, you'll have some recovery time and you'll go home. 

Kern:

Sounds good. 

Dr Aldred:

All right, I’m excited.

Kern:

We are, too.

TEXT ON-SCREEN:

In a 12-week clinical study, Duopa was shown to reduce “off” time and increase “on” time without troublesome movement (dyskinesia) from baseline compared to carbidopa/levodopa pills at Week 12.

Dr Aldred:

My hope for Kern is he will have less “off” time, his ability to move will be better, and he should have a benefit of increased “on” time. 

TEXT ON-SCREEN:

Preparing to start Duopa…

TEXT ON-SCREEN:

Talk to your doctor about how they might adjust your Duopa dose during titration, which may be different. 

Dr Aldred:

Today was Kern’s first day to start Duopa. On our titration days, we bring patients in off their medication. Kern came in off of all anti-Parkinson’s medication, and as a result of that, he was very off, very slow. 

TEXT ON-SCREEN:

Serious side effects can occur. Tell your doctor right away if you experience: falling asleep during normal daily activities without warning; low blood pressure when you stand or sit up quickly; seeing, hearing, or feeling things that are not real; unusual urges or compulsive behavior such as excessive gambling, compulsive eating or shopping, and increased sex drive. 

Kern:

Well, right now, I am in a real “off” period. 

Dr Aldred:

Well, we can move on to getting you treated. How about that? Let's turn on Duopa and get you feeling better.

TEXT ON-SCREEN:

Serious side effects can occur: depression and suicide; uncontrolled sudden movements (dyskinesia); progressive weakness, numbness, or loss of sensation in the fingers or feet. 

Dr Aldred voiceover:

For my patients, when I start Duopa, we’ll make some adjustments. And for a few days after that, we may bring them back for repeat titration visits.

TEXT ON-SCREEN:

Serious side effects can occur: heart attack or other heart problems including increased blood pressure, fast/irregular heartbeat, or chest pain; Parkinson’s disease patients are at increased risk of melanoma (a form of skin cancer); changes in certain blood tests including certain hormone and kidney tests; worsening of the increased pressure in your eyes (glaucoma).

Dr Aldred:

You may feel that the medicine on the first day wears off a little bit from time to time, and that’s okay. We in fact expect that. 

TEXT ON-SCREEN:

Serious side effects can occur: heart attack or other heart problems including increased blood pressure, fast/irregular heartbeat, or chest pain; Parkinson’s disease patients are at increased risk of melanoma (a form of skin cancer); changes in certain blood tests including certain hormone and kidney tests; worsening of the increased pressure in your eyes (glaucoma).

Dr Aldred:

And if that’s the case, we'll make some adjustments to get it right. 

Kern:

Well, I had initially a really slow improvement and then we had to increase it. So, I'd say, overall, it's been positive. 

TEXT ON-SCREEN:

Do not stop using DUOPA or change your dose unless you are told to do so by your healthcare provider. Tell your healthcare provider if you develop withdrawal symptoms such as fever, confusion, or severe muscle stiffness.

Dr Aldred:

This is just the beginning of our titration to get Kern on the right dose of Duopa that’s going to improve his “on” time and reduce his “off” time.  

TEXT ON-SCREEN:

3 weeks later…

Dr Aldred:

So, Kern, it’s been 3 weeks since we started Duopa treatment. Can you tell me what’s different? 

TEXT ON-SCREEN:

“Off”/”On” time is defined in terms of slowness, stiffness, and mobility. 

Kern:

I'm having less in the way of “off” episodes, and I feel better and move better. The “off” times have been less -- I think overall much improved.

Diana:

Before Duopa, we were living by the clock. Every 2 hours he had to take medicine and often in between, and so just having the pump running has been great. 

Kern:

I was just taking about 24 tablets a day of this carbidopa/levodopa this…the tablet. Now I'm down to about 2 a day. So, it really is significantly less, I would say.

Diana:

But also, he's just been much more level and not the ups and downs. 

Dr Aldred:

You've been probably pretty busy going about your business, I would think, as it's gotten better.

Kern voiceover:

I help a little bit with work out in the yard and so on, not much, but cleaning at home.

Dr Aldred:

Yes, sorry.

Dr Aldred:

Would you do it again if you had the choice so far?

Kern:

I would say yes, very positive about that. I was not sure at first when we got started, but I see the…the benefit now, and it really has been a good experience.

Dr Aldred:

Kern’s response to Duopa with reduction in “off” time and improvement in “on” time is a very typical response.

TEXT ON-SCREEN:

The most common side effects of DUOPA include: complications of tubing placement procedure, swelling of legs and feet, nausea, high blood pressure (hypertension), depression, and mouth and throat pain.

Diana voiceover:

Since Kern started using Duopa, he hasn’t had the downs that he had before. Not having the “off” times as much has been wonderful.

Kern voiceover:

I'm getting around much better. I go with her to the store – and pester her, like “I'm going to go with you,” and you say…

Kern:

“Oh, no, no, please don’t do that.” But I threaten that anyway.

[Kern and Diana laugh]

Diana voiceover:

As far as our decision to go ahead with Duopa, I am very pleased. When we first heard about it, it sounded so complicated, and yet we found it to be less complicated than I thought.

Kern:

Yes, I would say that the decision was the right one for us at this time for me, and it's been a very positive response. 

Diana voiceover:

Kern still has lots of ideas as to what he wants to do. 

Diana:

He loves to do things with our grandkids when we go out to the farm. I like that. Seems like we’re able to plan our day, and it feels nice.

Kern:

If I had to do this over again, yes, this is what I would do. 

TEXT ON-SCREEN:

Only you and your doctor can decide if Duopa is right for you. 

Kern:

And if I were asked by somebody about Duopa therapy, it’s something to consider. 

Kern:

And I’m glad that I did it.

TEXT ON-SCREEN and narrator:

Please watch the following Important Safety Information for DUOPA.

USE

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson’s disease. DUOPA contains two medicines: carbidopa and levodopa.

Important Safety Information

What is the most important safety information I should know about DUOPA?

  • Stomach and intestine (gastrointestinal) problems and problems from the procedure you will need to have to receive DUOPA (gastrointestinal procedure-related problems) may occur. Some of these problems may require surgery and may lead to death.
    • Serious side effects may include: a blockage of your stomach or intestines (bezoar); stopping movement through intestines (ileus); drainage, redness, swelling, pain, feeling of warmth around the small hole in your stomach wall (stoma); bleeding from stomach ulcers or your intestines; inflammation of your pancreas (pancreatitis); infection in your lungs (pneumonia); air or gas in your abdominal cavity; skin infection around the intestinal tube, pocket of infection (abscess), or infection in your blood (sepsis) or abdominal cavity may occur after surgery; stomach pain, nausea, or vomiting.
  • Tell your healthcare provider right away if you have any of the following symptoms of stomach and intestine problems and gastrointestinal procedure-related problems: stomach (abdominal) pain; constipation that does not go away; nausea or vomiting; fever; blood in your stool; or a dark tarry stool.

Your healthcare provider will talk to you about the stoma procedure. Before the stoma procedure, tell your healthcare provider if you ever had a surgery or problems with your stomach.

Talk to your healthcare provider about what you need to do to care for your stoma. After the procedure, you and your healthcare provider will need to regularly check the stoma for any signs of infection.

Do not take DUOPA if you currently take or have recently taken (within 2 weeks) a medication for depression called a non-selective monoamine oxidase (MAO) inhibitor. Ask your healthcare provider or pharmacist if you are not sure if you take an MAO inhibitor.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Using DUOPA with certain other medicines, including medications for high blood pressure, MAO inhibitors, antipsychotics, metoclopramide, isoniazid, and iron or vitamin supplements, may cause serious side effects. High-protein foods may affect how DUOPA works. Tell your healthcare provider if you change your diet.

DUOPA may cause serious side effects. Talk to your doctor before starting DUOPA and while on DUOPA if you have had or have any of these:

  • Falling asleep during normal daily activities without warning. DUOPA may cause you to fall asleep while you are doing daily activities such as driving, which may result in an accident. This can happen as late as one year after starting DUOPA. Do not drive or operate machinery until you know how DUOPA affects you. Tell your healthcare provider if you take medicines that can make you sleepy, such as sleep medicines, antidepressants, or antipsychotics.
  • Low blood pressure when you stand or sit up quickly. After you have been sitting or lying down, stand up slowly to help reduce dizziness, nausea, sweating, or fainting until you know how DUOPA affects you.
  • Seeing, hearing, or feeling things that are not real (hallucinations).
  • Unusual urges. Some people taking medicines for Parkinson's disease, including DUOPA, have reported urges such as excessive gambling, compulsive eating, compulsive shopping, and increased sex drive.
  • Depression and suicide. DUOPA can cause or worsen depression. Pay close attention to changes in your mood, behavior, thoughts, or feelings. Call your healthcare provider right away if you feel depressed or have thoughts of suicide.
  • Uncontrolled sudden movements (dyskinesia). If you have new dyskinesia or your dyskinesia gets worse, tell your healthcare provider. This may be a sign that your dose of DUOPA or other Parkinson's medicines may need to be adjusted.
  • Progressive weakness or numbness or loss of sensation in the fingers or feet (neuropathy).
  • Heart attack or other heart problems. Tell your healthcare provider if you have experienced increased blood pressure, a fast or irregular heartbeat, or chest pain.
  • Abnormal blood tests. DUOPA may cause changes in certain blood tests, especially certain hormone and kidney function blood tests.
  • Worsening of the increased pressure in your eyes (glaucoma). The pressure in your eyes should be checked after starting DUOPA.

Do not stop using DUOPA or change your dose unless you are told to do so by your healthcare provider. Tell your healthcare provider if you develop withdrawal symptoms such as fever, confusion, or severe muscle stiffness.

The most common side effects of DUOPA include: complications of tubing placement procedure, swelling of legs and feet, nausea, high blood pressure (hypertension), depression, and mouth and throat pain.

Please see the full Prescribing Information including Medication Guide for additional information about DUOPA. Talk to your healthcare provider if you have questions.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you are having difficulty paying for your medicine, AbbVie may be able to help. Visit AbbVie.com/myAbbVieAssist to learn more.

US-DUOP-200201

USE

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson's disease. DUOPA contains two medicines: carbidopa and levodopa.

IMPORTANT SAFETY INFORMATION 

What is the most important safety information I should know about DUOPA?

  • Stomach and instestine (gastrointestinal) problems and problems from the procedure you will need to have to receive DUOPA (gastrointestinal procedure-related problems)

USE

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson's disease. DUOPA contains two medicines: carbidopa and levodopa.

IMPORTANT SAFETY INFORMATION 

What is the most important safety information I should know about DUOPA?

  • Stomach and instestine (gastrointestinal) 

USE

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson's disease. DUOPA contains two medicines: carbidopa and levodopa.

IMPORTANT SAFETY INFORMATION 

What is the most important safety information I should know about DUOPA?

  • Stomach and instestine (gastrointestinal) problems and problems from the procedure you will need to have to receive DUOPA (gastrointestinal procedure-related problems)

USE

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson's disease. DUOPA contains two medicines: carbidopa and levodopa.

IMPORTANT SAFETY INFORMATION 

What is the most important safety information I should know about DUOPA?

  • Stomach and instestine (gastrointestinal)

USE

DUOPA (carbidopa and levodopa) enteral suspension is a prescription medicine used for treatment of advanced Parkinson’s disease. DUOPA contains two medicines: carbidopa and levodopa.

Important Safety Information

What is the most important safety information I should know about DUOPA?

  • Stomach and intestine (gastrointestinal) problems and problems from the procedure you will need to have to receive DUOPA (gastrointestinal procedure-related problems) may occur. Some of these problems may require surgery and may lead to death.
    • Serious side effects may include: a blockage of your stomach or intestines (bezoar); stopping movement through intestines (ileus); drainage, redness, swelling, pain, feeling of warmth around the small hole in your stomach wall (stoma); bleeding from stomach ulcers or your intestines; inflammation of your pancreas (pancreatitis); infection in your lungs (pneumonia); air or gas in your abdominal cavity; skin infection around the intestinal tube, pocket of infection (abscess), or infection in your blood (sepsis) or abdominal cavity may occur after surgery; stomach pain, nausea, or vomiting.
  • Tell your healthcare provider right away if you have any of the following symptoms of stomach and intestine problems and gastrointestinal procedure-related problems: stomach (abdominal) pain; constipation that does not go away; nausea or vomiting; fever; blood in your stool; or a dark tarry stool.

Your healthcare provider will talk to you about the stoma procedure. Before the stoma procedure, tell your healthcare provider if you ever had a surgery or problems with your stomach.

Talk to your healthcare provider about what you need to do to care for your stoma. After the procedure, you and your healthcare provider will need to regularly check the stoma for any signs of infection.

Do not take DUOPA if you currently take or have recently taken (within 2 weeks) a medication for depression called a non-selective monoamine oxidase (MAO) inhibitor. Ask your healthcare provider or pharmacist if you are not sure if you take an MAO inhibitor.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Using DUOPA with certain other medicines, including medications for high blood pressure, MAO inhibitors, antipsychotics, metoclopramide, isoniazid, and iron or vitamin supplements, may cause serious side effects. High-protein foods may affect how DUOPA works. Tell your healthcare provider if you change your diet.

DUOPA may cause serious side effects. Talk to your doctor before starting DUOPA and while on DUOPA if you have had or have any of these:

  • Falling asleep during normal daily activities without warning. DUOPA may cause you to fall asleep while you are doing daily activities such as driving, which may result in an accident. This can happen as late as one year after starting DUOPA. Do not drive or operate machinery until you know how DUOPA affects you. Tell your healthcare provider if you take medicines that can make you sleepy, such as sleep medicines, antidepressants, or antipsychotics.
  • Low blood pressure when you stand or sit up quickly. After you have been sitting or lying down, stand up slowly to help reduce dizziness, nausea, sweating, or fainting until you know how DUOPA affects you.
  • Seeing, hearing, or feeling things that are not real (hallucinations).
  • Unusual urges. Some people taking medicines for Parkinson's disease, including DUOPA, have reported urges such as excessive gambling, compulsive eating, compulsive shopping, and increased sex drive.
  • Depression and suicide. DUOPA can cause or worsen depression. Pay close attention to changes in your mood, behavior, thoughts, or feelings. Call your healthcare provider right away if you feel depressed or have thoughts of suicide.
  • Uncontrolled sudden movements (dyskinesia). If you have new dyskinesia or your dyskinesia gets worse, tell your healthcare provider. This may be a sign that your dose of DUOPA or other Parkinson's medicines may need to be adjusted.
  • Progressive weakness or numbness or loss of sensation in the fingers or feet (neuropathy).
  • Heart attack or other heart problems. Tell your healthcare provider if you have experienced increased blood pressure, a fast or irregular heartbeat, or chest pain.
  • Abnormal blood tests. DUOPA may cause changes in certain blood tests, especially certain hormone and kidney function blood tests.
  • Worsening of the increased pressure in your eyes (glaucoma). The pressure in your eyes should be checked after starting DUOPA.

Do not stop using DUOPA or change your dose unless you are told to do so by your healthcare provider. Tell your healthcare provider if you develop withdrawal symptoms such as fever, confusion, or severe muscle stiffness.

The most common side effects of DUOPA include: complications of tubing placement procedure, swelling of legs and feet, nausea, high blood pressure (hypertension), depression, and mouth and throat pain.

Please see the full Prescribing Information including Medication Guide for additional information about DUOPA. Talk to your healthcare provider if you have questions.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

If you are having difficulty paying for your medicine, AbbVie may be able to help. Visit AbbVie.com/myAbbVieAssist to learn more.

US-DUOP-200201