Intrajejunal vs oral levodopa-carbidopa therapy in Parkinson disease

Popa, Luminita Celia; Leucuţa, Daniel-Corneliu; Tohănean, Nicoleta; Popa, Stefan-Lucian; Perju‐Dumbravă, Lăcrămioara

doi:10.1097/md.0000000000023249

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…Caffein, as an A2A antagonist, may be a factor delaying the onset of LID [ 111 ]. The N-of-1 study on nicotine use demonstrated a significant effect of nicotine on the occurrence of LID compared to a placebo [ 112 ].…”

Section: Resultsmentioning

confidence: 99%

Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review

Hutny

Hofman

Klimkowicz‐Mrowiec

et al. 2021

JCM

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Levodopa remains the primary drug for controlling motor symptoms in Parkinson’s disease through the whole course, but over time, complications develop in the form of dyskinesias, which gradually become more frequent and severe. These abnormal, involuntary, hyperkinetic movements are mainly characteristic of the ON phase and are triggered by excess exogenous levodopa. They may also occur during the OFF phase, or in both phases. Over the past 10 years, the issue of levodopa-induced dyskinesia has been the subject of research into both the substrate of this pathology and potential remedial strategies. The purpose of the present study was to review the results of recent research on the background and treatment of dyskinesia. To this end, databases were reviewed using a search strategy that included both relevant keywords related to the topic and appropriate filters to limit results to English language literature published since 2010. Based on the selected papers, the current state of knowledge on the morphological, functional, genetic and clinical features of levodopa-induced dyskinesia, as well as pharmacological, genetic treatment and other therapies such as deep brain stimulation, are described.

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Section: Resultsmentioning

confidence: 99%

Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review

Hutny

Hofman

Klimkowicz‐Mrowiec

et al. 2021

JCM

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“…Among the therapeutic options for advanced PD, only Levodopa-carbidopa intestinal gel (LCIG) and deep brain stimulation (DBS) are currently available in Romania. The LCIG has gained increased attention from the Romanian researchers, with the publication of 11 studies [114,118,120,125,126,132,[138][139][140]142,143]. However, no studies on DBS were published in Romania, possibly due to the limited availability of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Parkinson’s Disease in Romania: A Scoping Review

et al. 2021

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Parkinson’s disease (PD) is a significant cause of disability, with a fast-growing prevalence. This review summarizes the epidemiological and clinical data, research on the diagnostic approaches and the interventions available in the Eastern European country of Romania. This scoping review follows the recommendations on the scoping review methodology by Joanna Briggs Institute. We searched four databases (up to 27 January 2021). The data of eligible studies were extracted in standardized forms. We identified 149 unique studies from 1133 records, with 11 epidemiological studies, 52 studies investigating clinical aspects of PD, 35 studies on diagnostic tools, and 51 intervention studies. A narrative synthesis is provided and placed in a historical context. Our review revealed a considerable increase in the Romanian research on PD in the latest 15 years, which largely follows international trends. However, we also identified several research gaps that provide useful information for policymakers, public health specialists, and clinicians.

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“…Gastric emptying is a rate-limiting step for orally administered levodopa, which is absorbed in the proximal small intestine 29 . Thus, gastric motility issues can lead to fluctuating plasma concentrations of levodopa, producing motor fluctuations 30 . The levodopa/carbidopa intestinal gel infusion system provides continuous carbidopa and levodopa infusion through a percutaneous endoscopic gastrojejunostomy (PEG-J) tube via a portable infusion pump 30 .…”

Section: Levodopa/carbidopa Intestinal Gel Infusionmentioning

confidence: 99%

“…30 The levodopa/carbidopa intestinal gel infusion system provides continuous carbidopa and levodopa infusion through a percutaneous endoscopic gastrojejunostomy (PEG-J) tube via a portable infusion pump. 30 An advantage of levodopa/carbidopa intestinal gel infusion over orally provided levodopa is that it can deliver continuous rather than pulsatile medication throughout the day, and delivery of the levodopa bypasses the stomach to the jejunum, avoiding problems that arise with gastric emptying issues. 26 By doing so, this stabilizes the motor fluctuations during the awake period, as plasma levodopa concentrations reach a steady state.…”

Section: Commentmentioning

confidence: 99%

“…Thus, gastric motility issues can lead to fluctuating plasma concentrations of levodopa, producing motor fluctuations 30 . The levodopa/carbidopa intestinal gel infusion system provides continuous carbidopa and levodopa infusion through a percutaneous endoscopic gastrojejunostomy (PEG-J) tube via a portable infusion pump 30 . An advantage of levodopa/carbidopa intestinal gel infusion over orally provided levodopa is that it can deliver continuous rather than pulsatile medication throughout the day, and delivery of the levodopa bypasses the stomach to the jejunum, avoiding problems that arise with gastric emptying issues 26 .…”

Section: Levodopa/carbidopa Intestinal Gel Infusionmentioning

confidence: 99%

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Surgical Therapies for Parkinson Disease

Rawls¹

2022

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW: Parkinson disease (PD) is a progressive neurodegenerative disorder that is often difficult to manage with medications alone. This article reviews the current therapeutic surgical interventions for PD, patient selection criteria, timing of patient referral to surgical services, procedure overview, and future directions.RECENT FINDINGS: Adaptive, or closed-loop, deep brain stimulation is a promising therapy that can detect ongoing circuit changes and deliver appropriate stimulation based on the patient's dominant symptom and level of dopaminergic medication.SUMMARY: Patients with PD can benefit from surgical interventions that can be added to their medication regimen. These patients should be referred to comprehensive centers that offer complete multidisciplinary screening evaluation to ensure appropriate patient selection and intervention selection. With the appropriate surgical intervention and continued management from their care team, patients with PD can maximize their quality of life.

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Intrajejunal vs oral levodopa-carbidopa therapy in Parkinson disease

Cited by 9 publications

References 20 publications

Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review

Current Knowledge on the Background, Pathophysiology and Treatment of Levodopa-Induced Dyskinesia—Literature Review

Parkinson’s Disease in Romania: A Scoping Review

Surgical Therapies for Parkinson Disease

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