Patient and caregiver outcomes with levodopa-carbidopa intestinal gel in advanced Parkinson's disease.


Journal

NPJ Parkinson's disease
ISSN: 2373-8057
Titre abrégé: NPJ Parkinsons Dis
Pays: United States
ID NLM: 101675390

Informations de publication

Date de publication:
30 Nov 2021
Historique:
received: 07 04 2020
accepted: 07 06 2021
entrez: 1 12 2021
pubmed: 2 12 2021
medline: 2 12 2021
Statut: epublish

Résumé

Levodopa-carbidopa intestinal gel (LCIG) has shown to be efficacious in motor and non-motor symptoms (NMS). Nevertheless, studies with patient Quality of Life (QoL) as a primary endpoint are scarce. To assess the effect of LCIG on Advanced Parkinson's Disease (APD) patients QoL. Secondarily, the impact on motor symptoms and NMS, emotional well-being, treatment satisfaction, and caregiver QoL, stress, disease burden, anxiety, depression, and work impairment were also investigated. In this prospective, 6-month multicenter postmarketing observational study, LCIG was administered to 59 patients with APD. Endpoints were assessed using validated scales and questionnaires. LCIG significantly improved patient QoL (PDQ-39 mean change ± standard deviation from baseline, -12.8 ± 14.6; P < 0.0001), motor symptoms (UPDRS-III in "On," -6.5 ± 11.8; P = 0.0002), NMS (NMSS, -35.7 ± 31.1; P < 0.0001), mood (Norris/Bond-Lader VAS, -6.6 ± 21.1; P = 0.0297), fatigue (PFS-16, -0.6 ± 1.0; P = 0.0003), depression (BDI-II, -5.1 ± 9.4; P = 0.0002), anxiety (BAI, -6.2 ± 9.6; P < 0.0001), and patient treatment satisfaction (SATMED-Q, 16.1 ± 16.8; P < 0.0001). There were significant correlations between the change from baseline to 6 months between PDQ-39 and UPDRS-IV, NMSS, BAI, BDI-II, AS, and PFS-16 scores, and Norris/Bond-Lader alertness/sedation factor. Caregiver anxiety also improved (Goldberg anxiety scale, -1.1 ± 1.0; P = 0.0234), but the clinical relevance of this finding is questionable. The serious adverse events reported were similar to those previously described for LCIG. In patients with APD, LCIG improves QoL, motor symptoms and NMS, emotional well-being, and satisfaction with the treatment. Improvement in patient QoL is associated with improvements in motor complications, NMS, anxiety, depression, apathy and fatigue. Improvements in patients' QoL does not correspond with improvements in caregivers' QoL or burden.

Identifiants

pubmed: 34848716
doi: 10.1038/s41531-021-00246-y
pii: 10.1038/s41531-021-00246-y
pmc: PMC8633325
doi:

Types de publication

Journal Article

Langues

eng

Pagination

108

Informations de copyright

© 2021. The Author(s).

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Auteurs

Francesc Valldeoriola (F)

Movement Disorders Unit, Neurology Service, Clínic Hospital, 170, Villarroel St., 08036, Barcelona, Spain. fvallde@clinic.cat.

María José Catalán (MJ)

Neurology Service, Clínico San Carlos Hospital, Profesor Martín Lagos St., 28040, Madrid, Spain.

Francisco Escamilla-Sevilla (F)

Movement Disorders Unit. Neurology Service, Virgen de las Nieves University Hospital, "Biohealth Investigation Institute. Ibs, Granada, Spain.

Eric Freire (E)

Neurology Service, Elche University General Hospital, 11, Camino Almazara St., 03203, Elche, Alicante, Spain.

Jesús Olivares (J)

Neurology Service, Torrecárdenas Hospital Center, Hermandad de Donantes de Sangre St., 04009, Almería, Spain.

Esther Cubo (E)

Neurology Service, Burgos University Hospital, 3, Islas Baleares Av., 09006, Burgos, Spain.

Diego Santos García (DS)

Department of Neurology, A Coruña University Hospital Center (CHUAC), A Coruña, Spain.

Matilde Calopa (M)

Neurology Service, Bellvitge University Hospital, Feixa Llarga St., 08907L'Hospitalet de Llobregat, Barcelona, Spain.

Pablo Martínez-Martín (P)

National Center of Epidemiology and Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, 5, Monforte de Lemos Av., 28029, Madrid, Spain.

Juan Carlos Parra (JC)

AbbVie Spain, S.L.U., 91, De Burgos Av., 28050, Madrid, Spain.

Gloria Arroyo (G)

AbbVie Spain, S.L.U., 91, De Burgos Av., 28050, Madrid, Spain.

José Matías Arbelo (JM)

Neurology Service, Insular of Gran Canaria University Hospital, Marítima del Sur Av., 35016, Las Palmas, de Gran Canaria, Spain.

Classifications MeSH