Intraduodenal levodopa-carbidopa intestinal gel infusion improves both motor performance and quality of life in advanced Parkinson’s disease

We report the efficacy and adverse effect profile of intraduodenal levodopa-carbidopa intestinal gel (LCIG) infusion from patients treated in a single Australian movement disorder centre. We conducted an open-label, 12month prospective study of treatment with LCIG in patients with advanced Parkinson’s disease in a single tertiary referral hospital unit specialising in movement disorders. Patients with levodopa-responsive, advanced Parkinson’s disease with motor fluctuations despite optimal pharmacological treatment were enrolled and underwent a 16hour daily infusion of LCIG for 12months. Fifteen participants completed the trial. The mean (±standard deviation) improvement in Unified Parkinson’s Disease Rating Scale part III was 37±11%, mean daily “off” period reduced from 6.3±2 to 1.9±2hours, total daily “on” time increased from 10.2±3 to 13.7±2hours, “on” period without dyskinesia increased from 4.5±3 to 7.5±5hours, and 39-item Parkinson’s Disease Questionnaire Summary Index score improved by 32.5±35%. The most common adverse event was reversible peripheral neuropathy secondary to vitamin B12±B6 deficiency (40%), local tube problems (40%), and impulse control disorder (ICD) (27%). No patient had stoma bleeding or peritonitis. All patients with ICD had a past psychiatric diagnosis of depression with or without anxiety and a higher daily levodopa intake at 6 and 12months of LCIG infusion. Intraduodenal LCIG improves motor performance, quality of li...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research