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NEUPRO® (rotigotine transdermal
system) is indicated for the treatment
of Parkinson's disease (PD).

Helping patients
feel ready to
take on the day

with NEUPRO.

Why NEUPRO?

NEUPRO improved activities
of daily living and motor
performance1

 

Mean baseline in UPDRS Parts II and Parts III combined
scores were 30 for the placebo group and 29.9 for NEUPRO-treated patients.2

 

“When my PD motor symptoms bother me, I’m tired and not myself. It feels like I’m losing a part of who I am.”

– JANE, PD patient

Activities of daily living and motor performance were measured by the UPDRS Parts II and III.1

  • NEUPRO demonstrated a clinically relevant change in UPDRS Parts II and III scores of -5.3 over placebo.1,3
  • The most common adverse reactions (at least 5% greater than placebo) for NEUPRO in the treatment of PD are nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, visual disturbance, peripheral edema, and dyskinesia.2
  • Data reflect a 6-month, multicenter, multinational, randomized, double-blind, placebo-controlled, prospective trial in patients (n=277) with early-stage, idiopathic PD. NEUPRO doses were titrated over 3 weeks to a maximum dose of 6 mg/24 h, followed by a 6-month maintenance phase. Primary outcomes were change from baseline in UPDRS Parts II and III combined scores at end of maintenance.1

 

“When my PD motor symptoms bother me, I’m tired and not myself. It feels like I’m losing a part of who I am.”

– JANE, PD patient

WHEN ADDED TO LEVODOPA

NEUPRO significantly
decreased “OFF” time for
PD patients2,4

 

 

“Because it’s a huge effort to get moving in the morning, I feel more tired throughout my day. How am I supposed to be able to get ready for work?”

– PAUL, PD patient

  • Onset of treatment benefit started as early as the first week of treatment.2
  • The most common adverse reactions (at least 5% greater than placebo) for NEUPRO in the treatment of PD are nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, visual disturbance, peripheral edema, and dyskinesia.2
  • A multinational, three-arm, parallel-group study in which 351 advanced-stage PD patients were titrated over 5 weeks to treatment with either placebo or NEUPRO (8 mg/24 hours or 12 mg/24 hours*) and maintained treatment for 24 weeks followed by a down titration over the last week.2

*12 mg/24 h is not an approved dose.2

Patient Characteristics

  • The mean daily intake of levodopa at baseline in the NEUPRO 8 mg/24 hours group was 760 mg/day vs 753 mg/day in the placebo group.4
  • Patients were required to have ≥2.5 hours of daily “OFF” time; the mean duration of daily “OFF” time at baseline was 6.8 hours in the NEUPRO 8 mg/24 hours group vs 6.4 hours in the placebo group.2,4
  • All patients had a Hoehn and Yahr stage between II and IV in both the “ON” and “OFF” states.4
  • 42% of patients included in the trial were <65 years old, 79% were <75, and 21% were ≥75.5

 

“Because it’s a huge effort to get moving in the morning, I feel more tired throughout my day. How am I supposed to be able to get ready for work?”

– PAUL, PD patient

WHEN ADDED TO LEVODOPA

NEUPRO increased
functional “ON” time
without troublesome
dyskinesias4

 

 

“I’ve made lots of changes to remain as independent as I can for as long as possible, but things still get harder each day. The more I have to ask for help, the worse I feel about myself.”

- ALBERTO, PD patient

  • NEUPRO may increase the dopaminergic side effects of levodopa and may cause or exacerbate pre-existing dyskinesia.2
  • The most common adverse reactions (at least 5% greater than placebo) for NEUPRO in the treatment of PD are nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, visual disturbance, peripheral edema, and dyskinesia.2
  • A multinational, three-arm, parallel-group study in which 351 advanced-stage PD patients were titrated over 5 weeks to treatment with either placebo or NEUPRO (8 mg/24 hours or 12 mg/24 hours*) and maintained treatment for 24 weeks followed by a down titration over the last week.2

*12 mg/24 h is not an approved dose.2

Patient Characteristics

  • The mean daily intake of levodopa at baseline in the NEUPRO 8 mg/24 hours group was 760 mg/day vs 753 mg/day in the placebo group.4
  • Patients were required to have ≥2.5 hours of daily “OFF” time; the mean duration of daily “OFF” time at baseline was 6.8 hours in the NEUPRO 8 mg/24 hours group vs 6.4 hours in the placebo group.2,4
  • All patients had a Hoehn and Yahr stage between II and IV in both the “ON” and “OFF” states.4
  • 42% of patients included in the trial were <65 years old, 79% were <75, and 21% were ≥75.5

 

“I’ve made lots of changes to remain as independent as I can for as long as possible, but things still get harder each day. The more I have to ask for help, the worse I feel about myself.”

- ALBERTO, PD patient

NEUPRO offers 24-hour
continuous, stable drug
delivery2,6

 

Stable plasma levels over
24 hours after reaching a steady state2

Measured in PD patients using the 8 mg/24 hours patch2

  • NEUPRO is a transdermal system that provides continuous delivery of rotigotine for 24 hours following application to intact skin.2
  • Relative bioavailability for the different application sites at steady-state was evaluated in subjects with PD. In a single trial conducted in early-stage PD, differences in bioavailability ranged from less than 1% (abdomen vs. hip) to 46% (shoulder vs. thigh) with shoulder application showing higher bioavailability.2

Setting patient expectations
about dosing and titration

Because the NEUPRO Patch is available in 4 sizes and doses (2-8 mg) to treat PD, it’s important to help patients understand what to expect and to address their possible questions, such as “Will my dosage need to change?”. You can let patients know that you may change their dose weekly based on their individual response and tolerability.2 They should also know it may take some time, possibly weeks, for them to feel the full effects of NEUPRO.2

Helping patients know what to expect when they
start using the NEUPRO Patch is important for their
treatment journey.

Early-stage PD

Initiate* the recommended starting dose of
2 mg/24 hours.

Initiate* the recommended starting dose
of 4 mg/24 hours.

Advanced-stage PD

*Based upon individual patient clinical response and tolerability, dosage may be increased in weekly increments of 2 mg/24 hours until an effective dose is reached.2



Patches not shown at actual size.

For early-stage PD:

  • The lowest effective dose is 4 mg/24 hours.2
  • The maximum recommended dose is 6 mg/24 hours.2

For advanced-stage PD:

  • The maximum recommended dose is 8 mg/24 hours.2

SETTING PATIENT EXPECTATIONS

About once-daily dosing
with the NEUPRO Patch2

There are some key things that patients will need to learn and remember to help them use their NEUPRO Patch properly.

Patients should be advised to read the Patient Information and Instructions for Use provided with their NEUPRO prescription before applying the patch.

The NEUPRO Patch should be applied at approximately the same time every day and worn for 24 hours. It should be removed and replaced after the patient has worn it for 24 hours.2

The NEUPRO Patch should be applied to clean, dry skin immediately after opening the pouch and pressed firmly in place for 30 seconds, with good contact around the edges. The warmth of the hand helps the adhesive stick to the skin.2

The NEUPRO Patch should not be applied to the same application site more than once every 14 days. It is important to rotate the application site daily to reduce the chance of skin irritations.2

SETTING PATIENT EXPECTATIONS

About adverse reactions
in early-stage PD

Adverse reactions in a placebo-controlled, fixed-dose trial in patients with early-stage PD

 

  • The safety of NEUPRO was evaluated in a total of 649 early-stage PD patients who participated in three double-blind, placebo-controlled studies with durations of 3 to 9 months. Additional safety information was collected in short-term studies and two open-label extension studies in patients with early-stage PD.2
  • ln the double-blind, placebo-controlled, dose-response study in patients with early-stage PD, the most common adverse reactions (at least 5% greater than placebo) for the maximum recommended dose of NEUPRO (6 mg/24 hours) were nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, and visual disturbance.2
  • 12% of patients treated with the maximum recommended NEUPRO dose (6 mg/24 hours) discontinued treatment because of adverse reactions, compared with 6% of patients who received placebo.2
  • Adverse reactions that occurred in greater than 2% of NEUPRO-treated patients and more frequent than in placebo-treated patients are shown.2
  • Incidences for the non-recommended 8 mg/24 hours dose are also shown.2

SETTING PATIENT EXPECTATIONS

About adverse reactions
in advanced-stage PD

Adverse reactions in a placebo-controlled, fixed-dose trial in patients with advanced-stage PD

 

 

  • The safety evaluation of NEUPRO was based on a total of 672 NEUPRO-treated patients with advanced-stage PD who participated in three double-blind, placebo-controlled studies (two fixed-dose trials and one flexible-dose trial) with durations of 3 to 7 months. Patients received concomitant levodopa in these studies. Additional safety information was collected in earlier short-term studies and two open-label extension studies in patients with advanced-stage PD.2
  • ln the dose-response, placebo-controlled trial for advanced-stage PD, the most common adverse reactions (at least 5% greater than placebo) for the maximum recommended dose of NEUPRO (8 mg/24 hours) were application site reactions, nausea, peripheral edema, dizziness, and dyskinesia.2
  • Approximately 15% of patients treated with the maximum recommended NEUPRO dose (8 mg/24 hours) discontinued treatment because of adverse reactions, compared with 9% of patients who received placebo.2
  • Adverse reactions that occurred in greater than 2% of NEUPRO-treated patients and more frequent than in placebo-treated patients are shown.2
  • Incidences for the non-recommended 12 mg/24 hours dose are also shown.2

Resources are available to
help your patients learn
about
NEUPRO at www.neupro.com.

As part of our commitment, NEUPRO offers a number of tools and resources to help patients with access to the medication and support throughout their treatment.

NEUPRO Patient Savings Program
Eligible patients pay as low as $10 a month for their NEUPRO prescriptions.*

For ineligible patients, UCB may be able to help through the Patient Assistance Program, which provides additional access to prescription coverage.

*Patients are not eligible if their prescriptions are paid in part or in full by any state or federally funded programs. Other eligibility restrictions, terms and conditions apply.
Click here for details.

Neupro Saving Card

Living with Parkinson’s disease isn’t easy, but the PD Coach App may help. The PD Coach App is a trusted resource that is there for your patients 24/7.

Take a few minutes to watch
this video on how to apply
the NEUPRO Patch

For help with rotating the patch every day, patients may download the NEUPRO Patch Placement Tracker.

Indication

NEUPRO is indicated for the treatment of Parkinson's disease.

Important Safety Information

NEUPRO contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people and is seen more frequently in people with asthma.

Patients treated with NEUPRO have reported somnolence and falling asleep without warning signs during activities of daily living, including driving, which sometimes resulted in accidents. Some patients believed they were alert immediately prior to the event. Patients may not recognize or acknowledge increased drowsiness or sleepiness. Therefore, prescribers should directly question patients about these possible occurrences and continually reassess patients, as some events have been reported well after the start of treatment. Patients should be advised to exercise caution while driving, operating heavy machinery, or working at heights during treatment with NEUPRO. If patients develop daytime sleepiness or episodes of falling asleep during activities of daily living, NEUPRO should be discontinued.

There is an increased risk for hallucinations in patients with advanced-stage Parkinson’s disease treated with NEUPRO. Patients also may experience new or worsening mental status and behavioral changes, which may be severe, including psychotic behavior during NEUPRO treatment or after starting or increasing the dose of NEUPRO.

NEUPRO may cause symptomatic postural/orthostatic hypotension, and Parkinson's disease patients appear to have an impaired capacity to respond to postural challenge. Patients treated with dopamine agonists require careful monitoring for signs and symptoms of postural hypotension, especially during dose escalation, and should be informed of this risk. NEUPRO may also cause syncope, elevated blood pressure, elevated heart rate, weight gain, and fluid retention. These events should be considered when treating patients with cardiovascular disease or concomitant illnesses.

Patients may experience intense urges to gamble, increased sexual urges, intense urges to spend money, binge eating, and other intense urges, and the inability to control these urges while taking medications, including NEUPRO, that increase central dopaminergic tone and that are generally used for the treatment of Parkinson's disease. Because patients may not recognize these behaviors as abnormal, prescribers should specifically ask patients and their caregivers about the development of new or increased urges while being treated with NEUPRO. Dose reduction or discontinuation of NEUPRO should be considered if such urges develop.

NEUPRO may increase the dopaminergic side effects of levodopa and may cause or exacerbate pre-existing dyskinesia.

NEUPRO can cause application site reactions, and some may be severe. In clinical trials, most reactions were mild or moderate in intensity and were limited to the patch area.

NEUPRO should be removed before magnetic resonance imaging or cardioversion, because the aluminum backing layer in the patch could cause skin burns. Heat application has been shown to increase absorption several fold with other transdermal products. Therefore, patients should be advised to avoid exposing the application site to sources of direct heat, such as heating pads or electric blankets, heat lamps, saunas, hot tubs, heated water beds, and prolonged direct sunlight.

The most common adverse reactions (at least 5% greater than placebo) for NEUPRO in the treatment of Parkinson's disease are nausea, vomiting, somnolence, application site reactions, dizziness, anorexia, disturbances in initiating and maintaining sleep, hyperhidrosis, visual disturbance, peripheral edema, and dyskinesia.

REFERENCES

  • 1. Watts RL, Jankovic J, Waters C, et al. Randomized, blind, controlled trial of transdermal rotigotine in early Parkinson disease. Neurology. 2007;68(4):272-276.
  • 2. NEUPRO [package insert]. Smyrna, GA: UCB Inc.
  • 3. Jankovic J, Watts RL, Martin W, et al. Transdermal rotigotine: double-blind, placebo-controlled trial in Parkinson disease. Arch Neurol. 2007;64(5):676-682.
  • 4. LeWitt PA, Lyons KE, Pahwa R. Advanced Parkinson disease treated with rotigotine transdermal system PREFER Study. Neurology. 2007;68:1262–1267.
  • 5. Data on File [SP650-PD4], Sect 8.2.12, UCB Inc.
  • 6. Elshoff JP, Braun M, Andreas JO, Middle M, Cawello W. Steady-state plasma concentration profile of transdermal rotigotine: an integrated analysis of three, open-label, randomized, phase I multiple dose studies. Clin Ther. 2012;34(4):966-978.