Long-term safety and effectiveness of levodopa-carbidopa intestinal gel infusion

Levodopa-carbidopa intestinal gel () infusion has demonstrated to improve motor fluctuations. The aim of this study is to assess the long-term safety and effectiveness of infusion in advanced Parkinson's disease () patients with motor fluctuations and its effect in nonmotor symptoms. Adverse ev...

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Autores: Fàbregues-Boixar i Nebot, Oriol de|||0000-0002-3518-5338, Dot, Joan|||0000-0001-5373-5367, Abu-Suboh Abadia, Monder|||0000-0003-2373-6400, Hernández-Vara, Jorge|||0000-0002-9129-5224, Ferré Masó, Alex|||0000-0002-3914-4154, Romero, Odile, Ibarria, Marta, Seoane, José Luis, Raguer, Nuria|||0000-0002-9471-9096, Puiggros, Carolina, Gómez, Maria Rosa, Quintana, Manuel|||0000-0003-0288-9088, Armengol, Josep Ramon, Álvarez Sabín, José|||0000-0002-8054-9209
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:235088
Acceso en línea:https://ddd.uab.cat/record/235088
https://dx.doi.org/urn:doi:10.1002/brb3.758
Access Level:acceso abierto
Palabra clave:Levodopa-carbidopa intestinal gel infusion
Motor fluctuations
Nonmotor symptoms
Parkinson
Safety
Descripción
Sumario:Levodopa-carbidopa intestinal gel () infusion has demonstrated to improve motor fluctuations. The aim of this study is to assess the long-term safety and effectiveness of infusion in advanced Parkinson's disease () patients with motor fluctuations and its effect in nonmotor symptoms. Adverse events () and their management, clinical motor, and nonmotor aspects were assessed up to 10 years. Thirty-seven patients were treated with ; in three subsets of patients, specific batteries of tests were used to assess cognitive and behavior assessment for 6 months, quality of sleep for 6 months, and quality of life and caregiver burden for 1 year. There was a high number of , but manageable, most of mild and moderate severity. All patients experienced significant improvement in motor fluctuations with a reduction in mean daily off time of 4.87 hr after 3 months (n = 37) to 6.25 hr after 9 years (n = 2). Diskynesias remained stables in 28 patients (75.7%) and improved in 5 patients (13.5%). There was no neuropsychological deterioration, but an improvement in attentional functions, voluntary motor control, and semantic fluency. Quality of sleep did not worsen, and there was an improvement in the subjective parameters, although overnight polysomnography did not change. There was a significant sustained improvement of 37% in -Q39 after 3 months and to 1 year, and a significant reduction in caregiver burden of 10% after 3 months. infusion is a safe and efficacious treatment for the control of motor fluctuations, and for improvement or nonworsening of nonmotor aspects, long-term sustained, and feasible for use in routine care.