Global long-term study on motor and non-motor symptoms and safety of levodopa-carbidopa intestinal gel in routine care of advanced Parkinson's disease patients; 12-month interim outcomes

Abstract

This observational, routine-care study supports long-term safety and efficacy of LCIG infusion in advanced PD including motor, non-motor and QoL improvements.

Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson’s disease: a multi-country Delphi-panel approach

“…the presence of caregiver/family support, access to a treatment center). The findings add to emerging literature on selection on device-aided therapies 42,45 by providing a multi-national expert view through a robust Delphi consensus process.…”

“…Recently published systematic reviews and consensus articles acknowledge that there is a growing need to establish guidelines and pragmatic clinical management approaches for the different treatment choices for PD patients requiring device-aided interventions [47][48][49][50] . Despite the potential clinical advantages, the total number of patients treated with device-aided therapies is still limited, due to the complexity of the procedure, difficulties in longterm patient management, and poor characterization of suitable candidates 45 . Our data complements the recent efforts, like in the NAVIGATE-PD (an educational program to supplement existing guidelines and provide recommendations of PD refractory to oral/transdermal therapies to understand clinical questions related to device-aided management of PD) 4 , which further the understanding of practical implica- with practical clinical experience and patient's preferences, can improve care 14,51 .…”

Levodopa/Carbidopa Intestinal Gel for Treatment of Advanced Parkinson’s Disease: An Update on the Effects of Cognitive Functions

“…Conversely, LCIG is less frequently associated with development or worsening of neuropsychiatric and cognitive complications. Indeed, recent studies reported improvement of NMS [64], including sleep disorders, fatigue, dysautonomic and cognitive symptoms following LCIG treatment in advanced PD patients.…”

Advanced stages of PD: interventional therapies and related patient-centered care

“…Adverse events are usually attributed to PEG-surgery and the PEG itself or to device complications, while LCIG itself Table 1 Overview on interventional treatment options in advanced stages of Parkinson's disease including recommendations DBS deep brain stimulation, LCIG levodopa-carbidopa intestinal gel, red not recommended, yellow may be considered, green recommended Advanced stages of PD: interventional therapies and related patient-centered care appears to be tolerated very well with very few side effects Fernandez et al 2014;Antonini et al 2015). In addition, most side effects occur early during LCIG treatment but are less frequent during further treatment.…”

“…LCIG therapy significantly decreased mean off-time and increased on-time without troublesome dyskinesia . Interestingly, in addition to levodopa-responsive motor symptoms LCIG was also shown to significantly improve non-motor symptoms, such as sleep, fatigue, attention, memory, gastrointestinal, urinary and cardiovascular symptoms, as well as the overall quality of life (Honig et al 2009;Fernandez et al 2014;Antonini et al 2015) Less improvement was observed for other symptoms, such as freezing and festination, postural instability as well as bulbar symptoms, such as dysphagia and dysarthria (Devos D, for the French DUODOPA Study Group 2009).…”