Levodopa infusion in Parkinson's disease: Individual quality of life

Ehlers, C. Til; Timpka, Jonathan; Odin, Per; Honig, H.

doi:10.1111/ane.13260

Cited by 7 publications

(9 citation statements)

References 38 publications

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“… 39 Most recently, a prospective, open‐label study of 12 patients followed for 6 months reported that LCIG improved individual QoL in both patients and caregivers as assessed by the Schedule for the Evaluation of Individual Quality of Life Questionnaire. 51 This improvement was observed despite no significant change in health‐related QoL, as assessed by the PDQ‐39, and was thought to be influenced by psychological factors given that family and relationships were rated highly by both patients and caregivers.…”

Section: Resultsmentioning

confidence: 95%

“… 42 , 48 , 49 A considerable number of studies indicate that LCIG positively affects QoL (Table 2 ). 12 , 13 , 14 , 16 , 17 , 37 , 38 , 40 , 50 , 51 , 52 Correlation analyses in one open‐label, observational, prospective study (n = 12; age: 73.8 ± 7.9 years; disease duration: 12.8 ± 5.0 years) did not show significant relationships between clinical conditions and QoL or between levels of anxiety, depression, and burden with caregiver QoL, possibly because of small patient numbers. 50 In a post hoc analysis of the GLORIA registry study (n = 233), moderate positive correlations were found between the NMSS total score and Parkinson's Disease Questionnaire (PDQ)‐8 total score (r = 0.46, P < 0.0001), improvements of the sleep/fatigue domain and PDQ‐8 total score (r = 0.32, P = 0.0001), and the mood/cognition domain and PDQ‐8 total score (r = 0.37, P < 0.0001) during a 2‐year period.…”

Section: Resultsmentioning

confidence: 99%

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Intrajejunal Infusion of Levodopa/Carbidopa for Advanced Parkinson's Disease: A Systematic Review

et al. 2021

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A BS TRACT: Advanced Parkinson's disease is inconsistently defined, and evidence is lacking in relation to device-aided therapies. To update existing reviews of intrajejunal infusion of levodopa/carbidopa (LCIG), we performed a literature search for relevant articles (to November 3, 2020) using PubMed supplemented by hand searching. Retrieved articles were categorized by relevance to identified research questions, including motor complications and symptoms; nonmotor symptoms; functioning, quality of life, and caregiver burden; optimal timing of treatment initiation and administration duration; discontinuation; and complications. Most eligible studies (n = 56) were open-label, observational studies including relatively small patient numbers. LCIG consistently reduces OFF time and increased ON time without troublesome dyskinesia with varying effects regarding ON time with troublesome dyskinesia and the possibility of diphasic dyskinesia. More recent evidence provides some increased support for the benefits of LCIG in relation to nonmotor symptoms, quality of life, activities of daily living, and reduced caregiver burden. Patient age does not appear to significantly impact the effectiveness of LCIG. Discontinuation rates with LCIG (~17%-26%) commonly relate to device-related issues, although the ability to easily discontinue LCIG may represent a potential benefit. LCIG may be a favorable option for patients with advanced Parkinson's disease who show predominant nonmotor symptoms and vulnerability to complications of other advanced therapy modalities. Larger, well-controlled studies, including precise investigation of cost effectiveness, would further assist treatment selection.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Intrajejunal Infusion of Levodopa/Carbidopa for Advanced Parkinson's Disease: A Systematic Review

et al. 2021

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“…9,14 Statistically significant data reported that the cause of therapy discontinuation in LCIG include the number of years that the patient had PD, fatigue caused by prolonged symptoms, and unfavorable events for therapeutic path continuation. 15,16 This continued worsening in symptoms subsequently leads to evaluation of alternative therapeutic options by the multidisciplinary team, always taking into consideration the patient's quality of life. 16,17…”

Section: Resultsmentioning

confidence: 99%

“…15,16 This continued worsening in symptoms subsequently leads to evaluation of alternative therapeutic options by the multidisciplinary team, always taking into consideration the patient's quality of life. 16,17…”

Section: Resultsmentioning

confidence: 99%

“…10 A significant element to consider in the initial evaluation is that the primary cause of discontinuation of such treatment is the number of years that the patient has had PD. 15,16 During the final phase of pre-LCIG evaluation, the nurse evaluates other no less important aspects, such as the number of years in which the patient was affected by PD, which often leads (because of the general clinical conditions) to treatment abandonment 15,16 ; tolerance or not to the weight of the infusion pump (often not suitable for the patient's state of wasting and malnutrition) 1 ; and initial phase of the LCIG treatment. 19 According to the scientific literature, the initial phase of nursing assessment, in combination with the multidisciplinary team, ensures the appropriate selection of candidates who have to face these therapeutic choices.…”

Section: Discussionmentioning

confidence: 99%

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The Prephase Nursing in Levodopa Carbidopa Intestinal Gel Therapy

Lezzi

Lupo

Lezzi

et al. 2022

Journal of Neuroscience Nursing

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INTRODUCTION:Parkinson disease (PD) affects approximately 1% of women and men worldwide, particularly older than 60 years. It is a multisystem and neurodegenerative disease with genetics and environmental factors that result in deficits in the production of neurotransmitters, including dopamine. The levodopa-carbidopa intestinal gel (LCIG) system delivers a continuous infusion of levodopa directly into the proximal small intestine via percutaneous endoscopic jejunostomy, largely bypassing gastric emptying and absorption problems and producing more stable plasma concentrations of levodopa, eliminating the development of motor complications (dyskinesias). The aim of this review was to summarize scientific evidence on the nursing role that, together with the multidisciplinary team, made the patient's choice in this therapeutic path (pre-LCIG phase). METHODS: A literature review was carried out, conducted on the MEDLINE databases (through PubMed), The Cochrane Library, Google Scholar, and CINAHL (through EBSCO). Relevant articles for the topic were found to identify indexed primary studies that investigated the relationship between the nurse and the patient/caregiver with PD who undertakes treatment with LCIG according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. RESULTS: Nineteen studies were included in the review. The selected studies suggested how the pre-LCIG phase of patient choice and the subsequent education and training could avoid selection errors for these therapeutic paths. CONCLUSION: Trained and specialized nursing staff who carry out an adequate pre-LCIG phase associated to the multidisciplinary team improved the choice of the patient and the start of treatment and, consequently, the quality of life of PD patients.

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Effects of levodopa/carbidopa intestinal gel infusion on autonomic symptoms in advanced Parkinson’s disease: a systematic review

Galli,

De Carolis,

Bianchini

et al. 2024

Clin Auton Res

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Purpose Autonomic failure has a major impact on the quality of life of individuals with Parkinson’s disease (PD), especially in advanced stages of the disease. Levodopa/carbidopa intestinal gel (LCIG) infusion is a well-established treatment for advanced PD with severe motor fluctuations and provides substantial benefit in managing some non-motor symptoms (NMS), such as sleep, fatigue, and neuropsychiatric issues. The effect of LCIG on autonomic symptoms is by contrast not well known. Here we performed a systematic review on the influence of LCIG therapy on autonomic dysfunction in PD individuals. Methods Following the PRISMA guidelines, we systematically searched for studies that included autonomic outcome measures in LCIG-treated PD individuals, limiting the search to articles written in English and published between January 2005 and June 2023. We evaluated improvement, stability, or worsening of gastrointestinal, urinary, and cardiovascular symptoms at six different timepoints according to clinimetric scale changes compared to baseline. Data on autonomic adverse events (AEs) possibly related to LCIG treatment were also collected. Results Of the 1476 studies identified in the initial search, 16 ultimately met the inclusion criteria and underwent quality assessment and data extraction, with data from 1361 PD patients (18.3 months mean follow-up). Thirteen studies reported improvement or stability of gastrointestinal, urinary, and cardiovascular symptoms over the interventional period. One study found a worsening of cardiovascular symptoms and two of urological symptoms. Regarding safety, seven studies reported gastrointestinal (8.4%), urinary (0.5%), and cardiovascular (1.1%) autonomic LCIG-related AEs. Conclusions LCIG infusion may help to reduce the burden of autonomic symptoms in advanced PD. Prospective studies specifically addressing the effect of LCIG on autonomic function in advanced PD are warranted.

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Levodopa infusion in Parkinson's disease: Individual quality of life

Cited by 7 publications

References 38 publications

Intrajejunal Infusion of Levodopa/Carbidopa for Advanced Parkinson's Disease: A Systematic Review

Intrajejunal Infusion of Levodopa/Carbidopa for Advanced Parkinson's Disease: A Systematic Review

The Prephase Nursing in Levodopa Carbidopa Intestinal Gel Therapy

Effects of levodopa/carbidopa intestinal gel infusion on autonomic symptoms in advanced Parkinson’s disease: a systematic review

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