Long‐term effect of levodopa‐carbidopa intestinal gel on axial signs in Parkinson’s disease

Fabbri, Margherita; Pongmala, Chatkaew; Artusi, Carlo Alberto; Romagnolo, Alberto; Rizzone, Mario Giorgio; Zibetti, Maurizio; Lopiano, Leonardo

doi:10.1111/ane.13110

Cited by 11 publications

(13 citation statements)

References 14 publications

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“…Another report found that axial symptoms in patients treated with LCIG remained relatively stable up to 1‐year follow‐up; however, that study included fewer patients and different stratification of patients by baseline H&Y scores. 42 Here, we also provide a description of those patients who completed 12 months of LCIG treatment, although no clinically meaningful differences were observed, it will be important for further studies to assess whether any of these characteristics are predictive of a positive response to LCIG therapy.…”

Section: Discussionmentioning

confidence: 99%

DUOGLOBE: One‐Year Outcomes in a Real‐World Study of Levodopa Carbidopa Intestinal Gel for Parkinson's Disease

Standaert

Aldred²,

Anca-Herschkovitsch

et al. 2021

Movement Disord Clin Pract

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Background Levodopa‐carbidopa intestinal gel (LCIG) is an established treatment for improving motor and some non‐motor symptoms (NMS) in patients with advanced Parkinson's disease (PD). Prospective long‐term data in routine clinical practice are limited. Objective Assess LCIG effectiveness and safety in patients with advanced PD after 12 months during real‐world routine clinical practice. Methods Duodopa/Duopa in patients with advanced Parkinson's disease—a global observational study evaluating long‐term effectiveness (DUOGLOBE) (NCT02611713) is an ongoing, prospective, multinational, observational study of LCIG‐naïve patients treated as part of routine clinical practice; 3 years of follow‐up are planned. The primary outcome is the change in patient‐reported off time. Other assessments include the Unified Dyskinesia Rating Scale (UDysRS), Non‐Motor Symptoms Scale (NMSS), Parkinson's Disease Sleep scale (PDSS‐2), Epworth Sleepiness Scale (ESS), health‐related quality of life (HR‐QoL), caregiver burden, and serious adverse events (SAEs). Outcomes from baseline to month (M) 12 are presented. Results In this 12‐month follow‐up, patients (N = 195) had baseline characteristics similar to other LCIG studies. Significant improvements (mean change to M12) were observed in off time (−3.9 ± 3.6 hr/day, P < 0.001), dyskinesia assessed using the UDysRS (−9.6 ± 22.5, P < 0.001), NMSS (−23.1 ± 41.4, P < 0.001), sleep and sleepiness symptoms on the PDSS‐2 (−6.5 ± 12.2, P < 0.001) and ESS (−1.0 ± 5.7, P < 0.05), HR‐QoL (−9.0 ± 21.6, P < 0.001), and caregiver burden (−1.9 ± 6.7, P = 0.008). Overall, 40.5% (n = 79) of patients experienced SAEs; fall (n = 6; 3.1%) and urinary tract infection (n = 6; 3.1%) were SAEs reported in ≥3% of patients. Conclusions These 12‐month outcome data show sustained, long‐term improvements and support the real‐world effectiveness of LCIG in patients with advanced PD. Safety was consistent with previous studies.

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Section: Discussionmentioning

confidence: 99%

DUOGLOBE: One‐Year Outcomes in a Real‐World Study of Levodopa Carbidopa Intestinal Gel for Parkinson's Disease

Standaert

Aldred²,

Anca-Herschkovitsch

et al. 2021

Movement Disord Clin Pract

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“…Although DAT may improve levodopa-responsive symptoms and reduce diurnal fluctuations, levodopa-refractory symptoms often become more apparent as PD progresses. 5) In some cases, axial symptoms, such as dysarthria 6) and falling, remain or worsen on behalf of improvement in motor function, 7) specific side effects such as apraxia of eyelid opening may occur, 6 , 8) and diurnal fluctuations may recur while DAT is used, 9) leading to a somewhat different clinical course compared with that when drug therapy alone is used. 10) DBS requires regular battery replacement and charging, restrictions on daily life to avoid electromagnetic interference, and risks of electrode and battery problems.…”

Section: Discussionmentioning

confidence: 99%

Development of Quality of Life Questionnaire for Patients with Parkinson’s Disease Undergoing STN-DBS

Kawaguchi

Miyagi

Kishimoto

et al. 2021

Neurol. Med. Chir.(Tokyo)

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In device-aided therapy (DAT) for Parkinson’s disease (PD), factors such as device-related adverse effects, psychological and lifestyle changes, and specific disease progression can affect the quality of life (QoL) of patients with advanced PD. However, there is no existing QoL scale that includes the effects of therapeutic devices. From a semi-structured interview with patients with PD undergoing deep brain stimulation (DBS), we extracted the content of utterances that were thought to affect the QoL and created a draft questionnaire consisting of 113 items. This questionnaire was administered to 54 other patients undergoing DBS, whose data were examined for reliability and validity by factor analysis, and finally, a 24-item PD QoL questionnaire for patients on DAT (PDQ-DAT) was developed. Presently, the PDQ-DAT is the only scale that can assess the QoL of patients on DAT, including the influence treatment devices have on them. In the future, it might be used to help in shared decision-making in medicine by incorporating the patient’s sense of burden and values in the selection of treatment methods.

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“…One may also hypothesize that troublesome dyskinesia played a role in the poor gait performance [20]. e study has limitations including a small sample size, the fact data was collected retrospectively, and that FOG was only measured using the UPDRS item 14. e relatively short follow-up may also be considered a limitation because, according to a recently published study [21], control over axial symptoms seems to diminish after 4 years of initiating LCIG.…”

Section: Discussionmentioning

confidence: 99%

Intestinal Levodopa/Carbidopa Infusion as a Therapeutic Option for Unresponsive Freezing of Gait after Deep Brain Stimulation in Parkinson’s Disease

González-Herrero

Jauma-Classen

Gómez-Llopico

et al. 2020

Parkinson's Disease

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Background. Treatment of freezing of gait (FOG) is always challenging because of its unpredictable nature and multifactorial physiopathology. Intestinal levodopa infusion has been proposed in recent years as a valuable option for its improvement. FOG in Parkinson’s disease (PD) can appear after deep brain stimulation in patients who never had gait symptoms. Objective. To study the effects of intestinal levodopa/carbidopa infusion in unresponsive-FOG that appears in PD patients treated with subthalamic nucleus deep brain stimulation. Methods. We retrospectively collected and analyzed demographic, clinical, and therapeutic data from five PD patients treated with subthalamic nucleus stimulation who developed unresponsive-FOG and received intestinal levodopa/carbidopa infusion as an alternative therapy. FOG was measured based on scores in item 14 of the Unified Parkinson’s Disease Rating Scale before and after intestinal levodopa infusion. Results. Administration of intestinal levodopa caused improvement of FOG in the “ON” state in four patients (80%) by 2 or more points in item 14 of the Unified Parkinson’s Disease Rating Scale. The improvement was maintained for at least 12 months. Conclusions. Intestinal levodopa infusion may be a valuable therapeutic option for unresponsive-FOG developed after subthalamic nucleus deep brain stimulation.

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Long‐term effect of levodopa‐carbidopa intestinal gel on axial signs in Parkinson’s disease

Cited by 11 publications

References 14 publications

DUOGLOBE: One‐Year Outcomes in a Real‐World Study of Levodopa Carbidopa Intestinal Gel for Parkinson's Disease

DUOGLOBE: One‐Year Outcomes in a Real‐World Study of Levodopa Carbidopa Intestinal Gel for Parkinson's Disease

Development of Quality of Life Questionnaire for Patients with Parkinson’s Disease Undergoing STN-DBS

Intestinal Levodopa/Carbidopa Infusion as a Therapeutic Option for Unresponsive Freezing of Gait after Deep Brain Stimulation in Parkinson’s Disease

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