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Long-term effect and reasons for switching and combining device-aided therapies in Parkinson's Disease.
Neurol Neurochir Pol
January 2025
Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Introduction: In the advanced stages of Parkinson's disease (PD), when standard drug adjustments fail to sufficiently improve patients' quality of life, device-aided therapies (DATs) such as deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion (CSAI), levodopa-carbidopa intestinal gel infusion (LCIG), levodopa-carbidopa-entacapone intestinal gel infusion, or continuous subcutaneous foslevodoa-foscarbidopa infusion are beneficial in the long run. However, sometimes patients need to switch or combine DATs due to either adverse events or loss of efficacy.
Aim Of Study: The aim of this article was to summarise the existing data on the long-term efficacy and adverse events of DATs, and to review the data on the rationale and efficacy for switching or combining DATs in advanced PD.
How well is the female population represented in clinical trials with infusion therapies for Parkinson's disease? A systematic review and metanalysis.
Eur J Neurol
January 2025
Parkinson and Movement Disorders Unit, Study Center for Neurodegenerative diseases (CESNE), Department of Neuroscience, Padua Neuroscience Center (PNC), University of Padua, Padua, Italy.
Background: Parkinson's disease (PD) is a neurodegenerative disorder affecting both sexes, but differences exist between male and female in clinical manifestations, functional impact of symptoms and hormonal influences. Therefore, representativeness of females in PD trials indirectly determines the external validity of the clinical research in this field.
Objective: To estimate the representativeness of female in infusion therapy trials for advanced PD.
Levodopa Pharmacokinetics in Switching from Levodopa/Carbidopa Intestinal Gel to Continuous Subcutaneous Foslevodopa/Foscarbidopa Infusion in a Patient with Parkinson's Disease: a case report.
J Mov Disord
January 2025
Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
Direct Initiation of Levodopa-Carbidopa Intestinal Gel Infusion After a Positive Levodopa Challenge Test in Advanced Parkinson's Disease.
Brain Behav
December 2024
Department of Neurology, Helsinki University Hospital, Helsinki, Finland.
Article Synopsis
- LCIG is a treatment for advanced Parkinson's disease, often starting with a nasojejunal tube (NJT) test phase, but some centers have initiated treatment directly with a PEG-J tube.
- A study compared these two methods in 33 advanced PD patients, evaluating treatment discontinuations, adverse events, and hospital stay length.
- Results showed no significant differences in complications or discontinuations between the two methods, but direct initiation with PEG-J reduced hospital stays significantly.
Effects of levodopa/carbidopa intestinal gel infusion on autonomic symptoms in advanced Parkinson's disease: a systematic review.
Clin Auton Res
December 2024
Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University of Rome, Via di Grottarossa, 1035, 00189, Rome, Italy.
Article Synopsis
- Autonomic failure significantly affects the quality of life for individuals with advanced Parkinson's disease (PD), prompting the need to evaluate the impact of Levodopa/carbidopa intestinal gel (LCIG) on autonomic dysfunction.
- A systematic review identified 16 studies involving 1361 PD patients, assessing the effects of LCIG on gastrointestinal, urinary, and cardiovascular symptoms over time, with most studies reporting improvements or stability.
- While many patients benefited from LCIG, some experienced worsening autonomic symptoms and there were reports of mild adverse events related to the treatment, highlighting the need for further targeted research in this area.
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