Multicenter study of levodopa carbidopa intestinal gel in Parkinson's disease: the Turkish experience

Background/aim: Our purpose was to determine the efficacy of levodopa carbidopa intestinal gel LCIG in a series of Turkish patients with Parkinson's disease PD . Materials and methods: We had telephone calls with 54 patients from 11 neurology centers who were on LCIG treatment, and 44 patients or their caregivers were included in an eight-item survey between September 2015 and June 2016. The reliability and validity of the survey were evaluated with intraclass correlation coefficients for every question separately.Results: Average age of the patients were 63.48 and the duration of PD was 12.79 years. Average LCIG treatment period was 15.63 months. Percentages of the patients who reported they were `better' after LCIG treatment were as follows: 80% for time spent off, 55% for dyskinesia, 65% for tremor, 85% for gait disorder, 50% for pain, 50% for sleep disorders, 42.5% for depression, 32.5% for incontinence, and 70% for activities of daily living. Cronbach's alpha was 0.795 and the intraclass correlation coefficient was reliable for the items.Conclusion: As detected by a survey performed by telephone calls with good interrater reliability, patients with PD improve with LCIG treatment in many aspects of the disease.

Keywords:

Parkinson's disease, levodopa carbidopa intestinal gel, efficacy,

PDF

___

1. Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurology 2006; 5: 525-535.
2. Lees AJ, Hardy J, Revesz T. Parkinson’s disease. Lancet 2009; 373: 2055-2066.
3. Antonini A, Chaudhuri KR, Martinez-Martin P, Odin P. Oral and infusion levodopa-based strategies for managing motor complications in patients with Parkinson’s disease. CNS Drugs 2010; 24: 119-129.
4. Tetrud JW. Balancing short-term symptom control and longterm functional outcomes in patients with Parkinson’s disease. CNS Spectrums 2007; 12: 275-286.
5. Stocchi F, Tagliati M, Olanow CW. Treatment of levodopainduced motor complications. Movement Disorders 2008; 23: 559-612.
6. Chang FCF, Kwan V, van der Poorten D, Mahant N, Wolfe N et al. Intraduodenal levodopa-carbidopa intestinal gel infusion improves both motor performance and quality of life in advanced Parkinson’s disease. Journal of Clinical Neuroscience 2016; 25: 41-45.
7. Fernandez HH, Standaert DG, Hauser RA, Lang AE, Fung VSC et al. Levodopa-carbidopa intestinal gel in advanced Parkinson’s disease: final 12-month, open-label results. Movement Disorders 2015; 30: 500-509.
8. Buongiorno M, Antonelli F, Cámara A, Puente V, De FabreguesNebot O et al. Long-term response to continuous duodenal infusion of levodopa/carbidopa gel in patients with advanced Parkinson disease: The Barcelona registry. Parkinsonism & Related Disorders 2015; 21: 871-876.
9. Virhammar J, Nyholm D. Levodopa carbidopa enteral suspension in advanced Parkinson’s disease: clinical evidence experience. Therapeutic Advances in Neurological Disorders 2017; 10: 171-187.
10. Martinez-Martin P, Reddy P, Katzenschlager R, Antonini A, Todorova A et al. EuroInf: A multicenter comparative observational study of apomorphine and levodopa infusion in Parkinson’s disease. Movement Disorders 2015; 30: 510-516.
11. Honig H, Antonini A, Martinez-Martin P, Forgacs I, Faye G et al. Intrajejunal levodopa infusion in Parkinson’s disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. Movement Disorders 2009; 24: 1468-1474.
12. Melgari J, Salomone G, Di Biase L, Marano M, Scrascia F et al. Dyskinesias during levodopa-carbidopa intestinal gel (LCIG) infusion: management in clinical practice. Parkinsonism & Related Disorders 20015; 21: 327-328.
13. Slevin J, Fernandez HH, Zadikoff C, Hall C, Eaton S et al. Long-term safety and maintenance of efficacy of levodopacarbidopa intestinal gel: an open-label extension of the double blind pivotal study in advanced Parkinson’s disease patients. Journal of Parkinson’s Disease 2015; 5: 165-174.
14. Fernandez HH, Vanagunas A, Odin P, Espay AJ, Hauser RA et al. Levodopa carbidopa intestinal gel in advanced Parkinson’s disease open-label study: interim results. Parkinsonism & Related Disorders 2013; 19: 339-345.
15. Olanow CW, Kieburtz K, Odin P, Espay AJ, Standaert DG et al. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson’s disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurology 2014; 13: 141-149.
16. Băjenaru O, Ene A, Popescu BO, Szasz JA, Sabau M et al. The effect of levodopa-carbidopa intestinal gel infusion long-term therapy on motor complications in advanced Parkinson’s disease: a multicenter Romanian experience. Journal of Neural Transmission 2016; 123: 407-414.
17. Cáceres-Redondo MT, Carrillo F, Lama MJ, HuertasFernández I, Vargas-González L et al. Long-term levodopa/ carbidopa intestinal gel in advanced Parkinson’s disease. Journal of Neurology 2014; 261: 561-569.
18. Wirdefeldt K, Odin P, Nyholm D. Levodopa carbidopa intestinal gel in patients with Parkinson’s disease: a systematic review. CNS Drugs 2016; 30: 381-404.
19. Antonini A, Yegin A, Preda C, Bergmann L, Poewe W. Global long-term study on motor and nonmotor symptoms and safety of levodopa–carbidopa intestinal gel in routine care of advanced Parkinson’s disease patients; 12-month interim outcomes. Parkinsonism & Related Disorders 2015; 21: 231- 235.
20. Sensi M, Preda F, Trevisani L, Contini E, Gragnaniello D et al. Emerging issues on selection criteria of levodopa carbidopa infusion therapy: considerations on outcome of 28 consecutive patients. Journal of Neural Transmission 2014; 121: 633-642.
21. Bohlega S, Abou Al-Shaar H, Alkhairallah T, Al-Ajlan F, Hasan N et al. Levodopa–carbidopa intestinal gel infusion therapy in advanced Parkinson’s disease: Single middle eastern center experience. European Neurology 2015; 74: 227-236.