Use of levodopa-carbidopa intestinal gel to treat patients with multiple system atrophy.
Continuous dopaminergic stimulation
Levodopa-carbidopa intestinal gel
Levodopa-responsiveness
Motor fluctuations
Multiple system atrophy
Journal
Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
07
01
2022
revised:
14
05
2022
accepted:
19
05
2022
pubmed:
19
6
2022
medline:
29
6
2022
entrez:
18
6
2022
Statut:
ppublish
Résumé
Levodopa-carbidopa intestinal gel (LCIG) is an effective treatment for late-stage Parkinson's disease (PD) but had not been evaluated in levodopa-responsive patients with the parkinsonian variant of multiple system atrophy (MSA-P) and motor fluctuations. We aimed to assess the safety of LCIG in MSA-P patients. In a retrospective, single-center study, we analyzed clinical and treatment-related data for all patients with MSA-P or PD treated with LCIG between December 2004 and November 2017. Adverse events (AEs) were classified into three classes: AEs related to gastrointestinal effects or to the PEG-J procedure, AEs related to the device, and AEs related to the pharmacological effect of LCIG. 7 MSA-P and 63 PD patients had been treated with LCIG for a median [interquartile range] period of 31 [16;43] and 19 [8;45] months, respectively. There were no significant intergroup differences in safety. Enteral nutrition was introduced at the same time as LCIG treatment in 4 (57%) MSA-P patients. In the MSA-P and PD groups, LCIG was associated with a better Global Clinical Impression score and discontinuation of oral anti-parkinsonian drugs (in 43% and 27% of cases, respectively). LCIG treatment is feasible in MSA-P patients with severe motor complications. The safety profile is similar to that seen in PD.
Sections du résumé
BACKGROUND
Levodopa-carbidopa intestinal gel (LCIG) is an effective treatment for late-stage Parkinson's disease (PD) but had not been evaluated in levodopa-responsive patients with the parkinsonian variant of multiple system atrophy (MSA-P) and motor fluctuations. We aimed to assess the safety of LCIG in MSA-P patients.
METHODS
In a retrospective, single-center study, we analyzed clinical and treatment-related data for all patients with MSA-P or PD treated with LCIG between December 2004 and November 2017. Adverse events (AEs) were classified into three classes: AEs related to gastrointestinal effects or to the PEG-J procedure, AEs related to the device, and AEs related to the pharmacological effect of LCIG.
RESULTS
7 MSA-P and 63 PD patients had been treated with LCIG for a median [interquartile range] period of 31 [16;43] and 19 [8;45] months, respectively. There were no significant intergroup differences in safety. Enteral nutrition was introduced at the same time as LCIG treatment in 4 (57%) MSA-P patients. In the MSA-P and PD groups, LCIG was associated with a better Global Clinical Impression score and discontinuation of oral anti-parkinsonian drugs (in 43% and 27% of cases, respectively).
CONCLUSIONS
LCIG treatment is feasible in MSA-P patients with severe motor complications. The safety profile is similar to that seen in PD.
Identifiants
pubmed: 35716627
pii: S1353-8020(22)00149-3
doi: 10.1016/j.parkreldis.2022.05.018
pii:
doi:
Substances chimiques
Antiparkinson Agents
0
Drug Combinations
0
Gels
0
Levodopa
46627O600J
Carbidopa
MNX7R8C5VO
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
41-44Informations de copyright
Copyright © 2022. Published by Elsevier Ltd.