Age/Disease Duration Influence on Activities of Daily Living and Quality of Life After Levodopa-Carbidopa Intestinal Gel in Parkinson’s Disease

Antonini, Angelo; Robieson, Weining; Bergmann, Lars; Yegin, Ashley; Poewe, Werner

doi:10.2217/nmt-2017-0046

Cited by 17 publications

(18 citation statements)

References 24 publications

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“…In line with this result, our study reported that the duration of off-time significantly affected patient QoL (Table 3). Interestingly, previous studies have reported inconsistent results in terms of whether age influences QoL in patients with PD [28,29]. In our study population of Japanese patients, the patient's age significantly affected QoL whereas a study conducted in Singapore showed an inconsistent result [28].…”

Section: Discussioncontrasting

confidence: 53%

“…In previous studies in Japanese and Malaysian populations, gastrointestinal disorders, such as constipation, were the commonly reported nonmotor symptoms [12,30]. In a study conducted in Italian patients with PD (n = 1072), gastrointestinal symptoms were reported by 61% of patients and worsened QOL [29]. In this JAQPAD study, apathy was associated with the worst QoL score, followed by cardiovascular symptoms, fatigue, attention/memory, and respiratory symptoms.…”

Section: Discussionmentioning

confidence: 54%

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Impact of motor and nonmotor symptoms in Parkinson disease for the quality of life: The Japanese Quality-of-Life Survey of Parkinson Disease (JAQPAD) study

Kurihara

Nakagawa

Ishido

et al. 2020

Journal of the Neurological Sciences

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Parkinson's disease (PD) is characterized by a range of classic motor symptoms and heterogeneous nonmotor symptoms that affect patients' quality of life (QoL). Studies have individually reported the effect of either motor or nonmotor symptoms on patients' QoL; however, a thorough assessment of the symptoms that have the greatest influence on QoL is limited. This JAQPAD study examined the effect of both motor and nonmotor symptoms and patient demographics on QoL in a large population of patients with PD in Japan. Methods: All members of the Japan Parkinson's Disease Association were invited to participate in the study. Questionnaires assessing wearing-off symptoms (the 9-item Wearing-Off Questionnaire [WOQ-9]), nonmotor symptoms (Non-Motor Symptoms Questionnaire [NMSQ]) and QoL (the 8-item Parkinson's Disease Questionnaire [PDQ-8]) were included. Multiple regression analyses assessed the effect of clinical factors on the PDQ-8 Summary Index (PDQ-8 SI). Spearman rank correlation coefficient (r) estimated the correlation between each subdomain score of nine NMSQ domains and the PDQ-8 SI. Results: A total of 3022 patients were included in the analysis. The PDQ-8 SI score correlated with off-time, age, duration of PD, work status, and the NMSQ total score and subdomain scores. Memory problems correlated most strongly with the PDQ-8 SI score (r = 0.4419), followed by mood (r = 0.4387) and digestive problems (r = 0.4341; p < 0.0001). Conclusions: Physicians tend to focus on motor symptoms, while nonmotor symptoms often go under-recognized in clinical practice. This JAQPAD study highlights the importance of recognition and management of both motor and nonmotor symptoms, which together significantly affect patient QoL.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 54%

Impact of motor and nonmotor symptoms in Parkinson disease for the quality of life: The Japanese Quality-of-Life Survey of Parkinson Disease (JAQPAD) study

Kurihara

Nakagawa

Ishido

et al. 2020

Journal of the Neurological Sciences

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“…Patients were also required to demonstrate a positive clinical response to LCIG administered via a temporary nasojejunal (NJ) tube prior to receiving a permanent PEG-J tube. Patients were enrolled from 75 movement disorder centers in Australia, Austria, Belgium, Bulgaria, Czech Republic, Denmark, France, Germany, Greece, Ireland, Italy, Netherlands, Norway, Romania, Slovenia, Spain, Switzerland, and the United Kingdom [13,14].…”

Section: Gloria Registrymentioning

confidence: 99%

Safety of Levodopa-Carbidopa Intestinal Gel Treatment in Patients with Advanced Parkinson’s Disease Receiving ≥2000 mg Daily Dose of Levodopa

Zadikoff

Poewe

Boyd

et al. 2020

Parkinson's Disease

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Background. Levodopa-carbidopa intestinal gel (LCIG) provides continuous levodopa administration and clinical benefits to patients with advanced Parkinson’s disease (PD). This report evaluates long-term safety and efficacy of high-dose LCIG in PD patients. Methods. Data were collected from several prospective, phase III clinical studies and an observational registry. The phase III program (N = 412) included four multicenter studies: a 12-week, randomized, double-blind study and three open-label studies extending ≥12 months. GLORIA (N = 375) was a 24-month, multicountry, observational registry. LCIG safety (adverse effects (AEs)/adverse drug reactions (ADRs)) and efficacy (modified Unified Parkinson’s Disease Rating Scale (UPDRS) part IV item 32 and 39 scores for “On” time with dyskinesia and “Off” time) were assessed in patients who received ≥2000 mg/day vs <2000 mg/day LCIG. Results. A total of 72 of 412 (17.5%) patients required dosages ≥2000 mg/day LCIG in the phase III program and 47 of 375 (12.5%) patients in GLORIA. Baseline demographics and disease severity were similar between dosage groups with more men in the high-dosage group. Compared with the <2000 mg/day dosage group, patients requiring ≥2000 mg/day LCIG had higher rates of AEs/ADRs including polyneuropathy; improvements in “Off” time and discontinuations due to AEs were similar between dosage groups and lower for discontinuations due to ADRs reported in GLORIA. Conclusions. Patients who require ≥2000 mg/day LCIG exhibited a safety profile comparable to the established safety/tolerability of LCIG with similar clinical improvements. Higher AEs were noted but within what is accepted for LCIG. Continuous administration of LCIG is beneficial to advanced PD patients who require very high doses of levodopa.

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“…Also, the percentage reductions of NMS and PDQ-8 vs BL were greater in the Italian sub-group analysis compared to the total GLORIA population even if the Italian group baseline “Off” time was lower (4.3 ± 2.7 vs 6.0 ± 3.2 h). This observation seems of interest considering that in another GLORIA sub-analysis, it was recently reported that the magnitude of QoL improvement was greater in patients with more “Off” time and larger LED dose at baseline [ 30 ]. LCIG led to significant improvements in UPDRS II and III scores, 24% and 17%, respectively, at M24.…”

Section: Discussionmentioning

confidence: 99%

Long-term effectiveness of levodopa-carbidopa intestinal gel on motor and non-motor symptoms in advanced Parkinson’s disease: results of the Italian GLORIA patient population

Antonini

Marano²,

Gusmaroli

et al. 2020

Neurol Sci

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Introduction The GLORIA registry included 375 advanced Parkinson’s disease (PD) patients and evaluated the efficacy and safety of a 24-month levodopa-carbidopa intestinal gel (LCIG) treatment in routine medical care. This analysis focuses on the Italian population, 60 patients treated with LCIG in 7 specialised PD care centres. Methods Hours of “Off” and “On” time were assessed with a modified version of the Unified Parkinson’s Disease Rating Scale (UPDRS) part IV items 39 and 32. Motor fluctuations, dyskinesia, non-motor symptoms, quality of life and safety were evaluated. Results Overall, 42 (70%) out of 60 patients completed the registry. LCIG treatment reduced “Off” time (− 3.3 ± 2.7 h at month 24 (M24), P < 0.0001), increased “On” time with dyskinesia (− 2.6 ± 5.2 h at M12, P = 0.0160), and improved UPDRS II and UPDRS III total scores at M24 (− 4.5 ± 10.6, P = 0.0333 and − 4.9 ± 11.7, P = 0.0229, respectively), Non-Motor Symptom Scale (NMSS) total score (− 21.8 ± 28.5, P < 0.0001) and Parkinson’s Disease Questionnaire-8 item (PDQ-8) total score (− 12.5 ± 23.9, P = 0.0173) versus previous oral therapy. Adverse drug reactions (ADR) possibly or probably related to treatment were reported in 16 (28.6%) patients. Decreased weight (7.1%), polyneuropathy (7.1%) and abdominal pain (5.4%) were the most frequent ADRs while device malfunction (5.4%) and medical device change (5.4%) were the most reported device complaints. Conclusions LCIG improved motor fluctuations, non-motor symptoms and quality of life over 24 months while tolerability was consistent with the established safety profile.

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Age/Disease Duration Influence on Activities of Daily Living and Quality of Life After Levodopa-Carbidopa Intestinal Gel in Parkinson’s Disease

Cited by 17 publications

References 24 publications

Impact of motor and nonmotor symptoms in Parkinson disease for the quality of life: The Japanese Quality-of-Life Survey of Parkinson Disease (JAQPAD) study

Impact of motor and nonmotor symptoms in Parkinson disease for the quality of life: The Japanese Quality-of-Life Survey of Parkinson Disease (JAQPAD) study

Safety of Levodopa-Carbidopa Intestinal Gel Treatment in Patients with Advanced Parkinson’s Disease Receiving ≥2000 mg Daily Dose of Levodopa

Long-term effectiveness of levodopa-carbidopa intestinal gel on motor and non-motor symptoms in advanced Parkinson’s disease: results of the Italian GLORIA patient population

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