Intraduodenal levodopa-carbidopa intestinal gel infusion improves both motor performance and quality of life in advanced Parkinson’s disease

Chang, Florence; Kwan, Vu; Poorten, David van der; Mahant, Neil; Wolfe, Nigel; Griffith, Jane; Tsui, David; Kim, Samuel D.; Fung, Victor S.C.

doi:10.1016/j.jocn.2015.05.059

Cited by 39 publications

(38 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The association between PNP and LCIG was evaluated in 17 studies, including a total of 211 patients. A total of 98 PNPs were described, with an acute or subacute onset in 35.7% of cases (n = 35).…”

Section: Resultsmentioning

confidence: 99%

“…The only study that did not find any correlations between PNP and LCIG dosage included participants that preventively received supplementation with vitB2, vitB6, vitB12, and folate. Twelve studies did not provide any measures of association between PNP and LCIG doses …”

Section: Resultsmentioning

confidence: 99%

“…There were 14 studies testing the association between PNP and vitB12, 10 of which (71.4%) showed a correlation between low levels of vitB12 and PNP (Supporting Information Table S1); 11 studies tested the association between PNP and Hcy, nine of which (81.8%) showed a correlation between high Hcy and PNP (Supporting Information Table S1); eight studies tested the association between PNP and folate, four of which (50.0%) showed a correlation between low levels of folate and PNP (Supporting Information Table S1); six studies tested the association between PNP and vitB6 reporting, in all cases, a correlation between low levels of vitB6 and PNP (Supporting Information Table S1); and two studies tested the association between PNP and MMA, reporting high levels of MMA in patients with PNP (Supporting Information Table S1).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Levodopa‐Induced Neuropathy: A Systematic Review

Romagnolo

Merola

Artusi

et al. 2018

Movement Disord Clin Pract

View full text Add to dashboard Cite

Background Background: Clinical, neurophysiological, and pathological evidence suggest an association between Parkinson's disease (PD) and peripheral neuropathy (PNP), with a possible causative role of levodopa metabolic products, such as homocysteine and methylmalonic acid. Methods Methods: We conducted a systematic review of studies reporting cases of PNP in L-dopa-treated PD patients indexed in PubMed between January 1990 and March 2018. ResultsResults: We identified 38 articles reporting cases of PNP in PD patients treated with oral L-dopa or with L-dopa/ carbidopa intestinal gel infusion (LCIG). Prevalence of PNP was 30.2% in the former group and 42.1% in the latter. Oral L-dopa was mostly associated with slowly progressive PNP, whereas LCIG showed an acute or subacute onset in 35.7% of cases. In both groups, there was an association between PNP and higher L-dopa doses, as well as with the following biochemical alterations: increased homocysteine; reduced vitamin B12; increased methylmalonic acid; and reduced vitamin B6. A skin biopsy was performed in 181 patients, showing signs of small fibers neuropathy in 169 (93.4%). Positive, yet preliminary, results were observed in patients receiving periodic vitamin supplementation. Conclusions Conclusions: Over one third of PD patients in treatment with L-dopa may develop PNP, with a significantly higher prevalence of acute and subacute forms in those receiving LCIG. Pathogenic mechanisms remain unclear, but possibly related to a complex interplay between peripheral neurodegenerative processes and L-dopa neurotoxic metabolites. Prospective, randomized, clinical trials are required to identify factors associated with the onset and progression of PD-associated PNP and clarify the protective role of B-group vitamin supplementation.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Levodopa‐Induced Neuropathy: A Systematic Review

Romagnolo

Merola

Artusi

et al. 2018

Movement Disord Clin Pract

View full text Add to dashboard Cite

show abstract

“…Even though the mechanisms behind the disease have become better understood, which has led to better pharmacological treatment in recent years, parts of the mechanisms are not fully understood yet, such as how adverse reactions to levodopa evolve . Patients with PD and a fluctuating response to oral levodopa may be treated with continuous levodopa‐carbidopa intestinal gel (LCIG), which generally leads to a better quality of life . This is because continuous levodopa allows for a stable levodopa plasma concentration which minimizes patients’ motor fluctuations .…”

Section: Introductionmentioning

confidence: 99%

The effect of continuous levodopa treatment during the afternoon hours

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that HrQoL in PD is reduced when fluctuations occur . For some (mainly motor) fluctuations, there is effective management available that has been shown to improve HrQoL . The continuous objective assessment of fluctuations is of high clinical relevance because comparable to dyskinesia assessment, there is reduced compliance, recall bias, and diary fatigue .…”

Section: Which Pd Features Should Be Prioritized In the Development Omentioning

confidence: 99%

A clinical view on the development of technology-based tools in managing Parkinson's disease

2016

View full text Add to dashboard Cite

Recently, quantitative, objective, and easy-to-use technology-based tools that can assess PD features over long time periods have been developed and generate clinically relevant and comparable patient information. Herein, we present a clinician's view on technological developments that have the potential to revolutionize clinical management concepts in PD. According to prominent examples in clinical medicine (e.g., blood glycosylated hemoglobin and blood pressure), we argue that the consideration of technology-based assessment in the clinical management of PD must be based on specific assumptions: (1) It provides a valid and accurate parameter of a clinically relevant feature of the disease; (2) there is confirmed evidence that the parameter has an ecologically relevant effect on the specific clinical application; (3) a target range can be defined wherein the parameter reflects the adequate treatment response; and (4) implementation is simple to allow repetitive use. Currently, there are no technology-based tools available that fulfil all these assumptions; however, assessments of akinesia, dyskinesia, motor fluctuations, physical inactivity, gait impairment, and postural instability seem relatively close to the specifications described. An iterative process of integration is recommended to bring technology-based tools into clinical practice. © 2016 International Parkinson and Movement Disorder Society.

show abstract

Intraduodenal levodopa-carbidopa intestinal gel infusion improves both motor performance and quality of life in advanced Parkinson’s disease

Cited by 39 publications

References 25 publications

Levodopa‐Induced Neuropathy: A Systematic Review

Levodopa‐Induced Neuropathy: A Systematic Review

The effect of continuous levodopa treatment during the afternoon hours

A clinical view on the development of technology-based tools in managing Parkinson's disease

Contact Info

Product

Resources

About