Levodopa/carbidopa intestinal gel can improve both motor and non-motor experiences of daily living in Parkinson’s disease: An open-label study

Juhász, Annamária; Aschermann, Zsuzsanna; Ács, Pongrác; Janszky, József; Kovács, Márton; Makkos, Attila; Harmat, Márk; Tényi, Dalma; Karádi, Kázmér; Komoly, Sámuel; Takáts, Annamária; Tóth, A.; Nagy, Helga; Klivényi, Péter; Dibó, Gábor; Dézsi, Lívia; Zádori, Dénes; Annus, Ádám; Vécsei, László; Varannai, Lajos; Kovács, Norbert

doi:10.1016/j.parkreldis.2017.02.001

Cited by 40 publications

(47 citation statements)

References 27 publications

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“…Similar improvements of NMSs and QoL were demonstrated in two other open-label studies with smaller patient collectives over a 12-month and a mean 48-month follow-up period [29,30].…”

Section: Discussionsupporting

confidence: 78%

Burden of non‐motor symptoms in Parkinson's disease patients predicts improvement in quality of life during treatment with levodopa‐carbidopa intestinal gel

Antonini

Robieson

Sánchez-Soliño

et al. 2018

Euro J of Neurology

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Background and purpose GLORIA , a registry conducted with 375 advanced Parkinson's disease patients treated with levodopa‐carbidopa intestinal gel ( LCIG ) for 24 months in routine clinical care, demonstrated significant reductions from baseline in ‘off’ time and ‘on’ time with dyskinesia and improvements in the Non‐Motor Symptom Scale ( NMSS ) total and individual domain scores, and in Parkinson's Disease Questionnaire 8 item ( PDQ ‐8) total score. Methods Associations between baseline NMSS burden ( NMSB ), the multi‐domain NMSS total score and the PDQ ‐8 total score were investigated for 233 patients. Baseline NMSB was assigned to five numerical categories defined by the NMSS total cutoff scores (0–20, 21–40, 41–60, 61–80 and >80). Pearson and Spearman correlations were calculated at month 24. Results The response of LCIG was assessed using validated criteria after 24 months. The proportion of patients decreasing ≥ 30 NMSS score points was 47% in the most affected NMSB category ( NMSS total score > 80). A positive association was noted between baseline NMSB and NMSS total score (0.57, P < 0.0001), as well as between NMSS total score and PDQ ‐8 total score (0.46, P < 0.0001). Associations between improvements of the NMSS domain sleep/fatigue and PDQ ‐8 total score (0.32, P = 0.0001) as well as between the NMSS domain mood/cognition and PDQ ‐8 total score (0.37, P < 0.0001) were also shown. Conclusions This analysis demonstrated positive associations between NMSS baseline burden and improvements of non‐motor symptoms. Improvements of non‐motor symptoms were associated with improved quality of life in advanced parkinsonian patients during a 2‐year treatment with LCIG and reflect the long‐term non‐motor efficacy of this treatment.

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“…Similar improvements of NMSs and QoL were demonstrated in two other open-label studies with smaller patient collectives over a 12-month and a mean 48-month follow-up period [29,30].…”

Section: Discussionsupporting

confidence: 78%

Burden of non‐motor symptoms in Parkinson's disease patients predicts improvement in quality of life during treatment with levodopa‐carbidopa intestinal gel

Antonini

Robieson

Sánchez-Soliño

et al. 2018

Euro J of Neurology

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“…23 A further difficulty is that in many publications there are dose adjustments (levodopa equivalent dose -LED and levodopa equivalent daily dose -LEDD), from which it is sometimes difficult to infer LD doses. 24,25 In previous publications, prior to the introduction of various DAT, mean LD doses in APD ranged from 884 to 1077 mg [26][27][28][29][30][31][32] and 1152 and 1485 mg (LEDD), respectively. 33,34 The LD doses that we report in this study are at the lower end of the range, but there are several explanations for this.…”

Section: Discussionmentioning

confidence: 99%

<p>Profile Of Patients With Advanced Parkinson’s disease Suitable For Device-Aided Therapies: Restrospective Data Of A Large Cohort Of Romanian Patients</p>

Szász

Constantin²,

Orbán-Kis

et al. 2019

NDT

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Background: There is insufficient data in the literature regarding the real-life, daily clinical practice evaluation of patients with advanced Parkinson's disease (APD). We are not sure what is the upper limit of dopaminergic medication, especially the levodopa (LD) dosage, and how it is influenced by access and suitability to the various add-on and device-aided therapies (DAT). Objective: This retrospective study explored the profile of APD patients that were considered and systematically evaluated regarding the suitability for DAT. Methods: We analyzed the data from 311 consecutive patients with APD hospitalized between 2011 and 2017 that 1) described at least 2 hrs/day off periods divided into at least two instances/day (except early morning akinesia), 2) were in stage 3 or above on the Hoehn and Yahr scale, 3) were with or without dyskinesia, and 4) received at least four levodopa doses/day combined with adjuvant therapy. Results: Of the 311 patients enrolled initially, 286 patients showed up for the second visit, of which in 125 cases we assessed that DAT would be necessary. Finally, 107 patients were tested in our clinic to confirm the efficacy of LCIG. Patients selected for DAT had significantly longer off periods, more frequent dyskinesia, early morning akinesia, and freezing despite having significantly higher LD doses than those with an improved conservative therapy. Conclusion: Patients with APD can have a variety of symptoms, and because symptoms and therapeutical efficacy can be manifested in many different combinations, it is not possible to decide using a single, rigid set of criteria which APD patient is eligible for DAT. Nevertheless, treating physicians should refer APD patients to a specialized movement disorder center when patients with an average daily dose of LD of at least 750-1000 mg and maximal complementary therapies present daily motor complications that significantly reduce the quality of life.

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“…Except for the dose of 260 mg, the MDS-UPDRS MC scores improved in both statistically significant and clinically relevant manners. In their pooled analysis published recently [28] , which also meet our criteria for clinical relevance [29].…”

Section: Discussionmentioning

confidence: 99%

Minimal clinically important difference for the historic parts of the Unified Dyskinesia Rating Scale

Makkos

Kovács

Pintér

et al. 2019

Parkinsonism & Related Disorders

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Levodopa/carbidopa intestinal gel can improve both motor and non-motor experiences of daily living in Parkinson’s disease: An open-label study

Abstract: As far as the authors are aware of, our paper is the first to evaluate the impact of LCIG on dyskinesia by the means of UDysRS. Changes in MDS-UPDRS and UDysRS confirm that LCIG treatment can efficiently improve experiences of daily living in advanced PD.

Cited by 40 publications

References 27 publications

Burden of non‐motor symptoms in Parkinson's disease patients predicts improvement in quality of life during treatment with levodopa‐carbidopa intestinal gel

Burden of non‐motor symptoms in Parkinson's disease patients predicts improvement in quality of life during treatment with levodopa‐carbidopa intestinal gel

<p>Profile Of Patients With Advanced Parkinson’s disease Suitable For Device-Aided Therapies: Restrospective Data Of A Large Cohort Of Romanian Patients</p>

Minimal clinically important difference for the historic parts of the Unified Dyskinesia Rating Scale

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