Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease

Background: treatment of intraduodenal levodopa using percutaneous endoscopic gastrostomy is an alternative therapy in patients with advanced Parkinson's disease. There are few studies that have evaluated the endoscopic aspects of this technique. Objectives: to describe our experience and adver...

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Autores: Garrido-Duran, Carmen, Khorrami Minaei, Sam, Sendra Rumbeu, Pau, Fernández García, Joaquín, Garcia Hernandez, Marcelo, Legarda, Inés
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/22649
Acceso en línea:https://hdl.handle.net/20.500.12105/22649
Access Level:acceso abierto
Palabra clave:Parkinson's disease
Levodopa
Percutaneous endoscopic gastrostomy
Continuous enteral infusion
Femenino
Duodenoscopía
Masculino
Carbidopa
Gastrostomía
Combinación de Medicamentos
Humanos
Persona de Mediana Edad
Anciano
Enfermedad de Parkinson
Estudios Retrospectivos
Antiparkinsonianos
Aged
Antiparkinson Agents
Drug Combinations
Humans
Middle Aged
Gastrostomy
Parkinson Disease
Duodenoscopy
Male
Female
Retrospective Studies
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spelling Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's diseaseGarrido-Duran, CarmenKhorrami Minaei, SamSendra Rumbeu, PauFernández García, JoaquínGarcia Hernandez, MarceloLegarda, InésParkinson's diseaseLevodopaPercutaneous endoscopic gastrostomyContinuous enteral infusionFemeninoLevodopaDuodenoscopíaMasculinoCarbidopaGastrostomíaCombinación de MedicamentosHumanosPersona de Mediana EdadAncianoEnfermedad de ParkinsonEstudios RetrospectivosAntiparkinsonianosAgedAntiparkinson AgentsDrug CombinationsHumansCarbidopaMiddle AgedGastrostomyLevodopaParkinson DiseaseDuodenoscopyMaleFemaleRetrospective StudiesBackground: treatment of intraduodenal levodopa using percutaneous endoscopic gastrostomy is an alternative therapy in patients with advanced Parkinson's disease. There are few studies that have evaluated the endoscopic aspects of this technique. Objectives: to describe our experience and adverse events regarding this technique in advanced Parkinson's disease. Method: a retrospective study was performed from January 2007 to January 2019 in a tertiary healthcare center. Results: thirty-seven patients aged 65.1 +/- 10.3 years were included in the study, 21 were male and the disease duration was ten years (1-26). The median follow-up was 16 months (1-144). The device was successfully placed in all cases.The persistence rate with the PEG-D at the end of follow-up was 62.2%.The system was removed in 14 patients, seven due to neurological impairment, four because of the decision of the patient and three due to related events. Fifty-nine adverse events occurred in 23 patients (62.2%, 0.63 per patient-year), four of which were severe (8.1%, 0.05 per patient-year). Minor adverse events included 14 (37.8%) related to the stoma, six (16.2%) to the gastric tube and 15 (40.5%) to the duodenal tube. Forty-four system replacements were performed in 20 patients (54.1%, 0.52 per patient-year). Male sex, age over 70 and a higher comorbidity index were associated with a greater likelihood of persistence of the system (OR: 0.14, 95% CI: 0.03-0.62; OR: 0.52, 95% CI: 0.32-0.86; OR: 0.16, 95% CI: 0.03-0.99, respectively). No predictors of adverse events associated with PEG-D were identified. Conclusions: percutaneous endoscopic gastrostomy for the continuous delivery of duodenal levodopa is a highly effective technique. Adverse events are common, although most are resolved by endoscopy.Arán Ediciones20242024-09-1020192019-01-0120192019-01-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articlehttps://hdl.handle.net/20.500.12105/22649reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/226492026-06-12T12:43:37Z
dc.title.none.fl_str_mv Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
title Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
spellingShingle Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
Garrido-Duran, Carmen
Parkinson's disease
Levodopa
Percutaneous endoscopic gastrostomy
Continuous enteral infusion
Femenino
Levodopa
Duodenoscopía
Masculino
Carbidopa
Gastrostomía
Combinación de Medicamentos
Humanos
Persona de Mediana Edad
Anciano
Enfermedad de Parkinson
Estudios Retrospectivos
Antiparkinsonianos
Aged
Antiparkinson Agents
Drug Combinations
Humans
Carbidopa
Middle Aged
Gastrostomy
Levodopa
Parkinson Disease
Duodenoscopy
Male
Female
Retrospective Studies
title_short Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
title_full Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
title_fullStr Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
title_full_unstemmed Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
title_sort Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease
dc.creator.none.fl_str_mv Garrido-Duran, Carmen
Khorrami Minaei, Sam
Sendra Rumbeu, Pau
Fernández García, Joaquín
Garcia Hernandez, Marcelo
Legarda, Inés
author Garrido-Duran, Carmen
author_facet Garrido-Duran, Carmen
Khorrami Minaei, Sam
Sendra Rumbeu, Pau
Fernández García, Joaquín
Garcia Hernandez, Marcelo
Legarda, Inés
author_role author
author2 Khorrami Minaei, Sam
Sendra Rumbeu, Pau
Fernández García, Joaquín
Garcia Hernandez, Marcelo
Legarda, Inés
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Parkinson's disease
Levodopa
Percutaneous endoscopic gastrostomy
Continuous enteral infusion
Femenino
Levodopa
Duodenoscopía
Masculino
Carbidopa
Gastrostomía
Combinación de Medicamentos
Humanos
Persona de Mediana Edad
Anciano
Enfermedad de Parkinson
Estudios Retrospectivos
Antiparkinsonianos
Aged
Antiparkinson Agents
Drug Combinations
Humans
Carbidopa
Middle Aged
Gastrostomy
Levodopa
Parkinson Disease
Duodenoscopy
Male
Female
Retrospective Studies
topic Parkinson's disease
Levodopa
Percutaneous endoscopic gastrostomy
Continuous enteral infusion
Femenino
Levodopa
Duodenoscopía
Masculino
Carbidopa
Gastrostomía
Combinación de Medicamentos
Humanos
Persona de Mediana Edad
Anciano
Enfermedad de Parkinson
Estudios Retrospectivos
Antiparkinsonianos
Aged
Antiparkinson Agents
Drug Combinations
Humans
Carbidopa
Middle Aged
Gastrostomy
Levodopa
Parkinson Disease
Duodenoscopy
Male
Female
Retrospective Studies
description Background: treatment of intraduodenal levodopa using percutaneous endoscopic gastrostomy is an alternative therapy in patients with advanced Parkinson's disease. There are few studies that have evaluated the endoscopic aspects of this technique. Objectives: to describe our experience and adverse events regarding this technique in advanced Parkinson's disease. Method: a retrospective study was performed from January 2007 to January 2019 in a tertiary healthcare center. Results: thirty-seven patients aged 65.1 +/- 10.3 years were included in the study, 21 were male and the disease duration was ten years (1-26). The median follow-up was 16 months (1-144). The device was successfully placed in all cases.The persistence rate with the PEG-D at the end of follow-up was 62.2%.The system was removed in 14 patients, seven due to neurological impairment, four because of the decision of the patient and three due to related events. Fifty-nine adverse events occurred in 23 patients (62.2%, 0.63 per patient-year), four of which were severe (8.1%, 0.05 per patient-year). Minor adverse events included 14 (37.8%) related to the stoma, six (16.2%) to the gastric tube and 15 (40.5%) to the duodenal tube. Forty-four system replacements were performed in 20 patients (54.1%, 0.52 per patient-year). Male sex, age over 70 and a higher comorbidity index were associated with a greater likelihood of persistence of the system (OR: 0.14, 95% CI: 0.03-0.62; OR: 0.52, 95% CI: 0.32-0.86; OR: 0.16, 95% CI: 0.03-0.99, respectively). No predictors of adverse events associated with PEG-D were identified. Conclusions: percutaneous endoscopic gastrostomy for the continuous delivery of duodenal levodopa is a highly effective technique. Adverse events are common, although most are resolved by endoscopy.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019-01-01
2019
2019-01-01
2024
2024-09-10
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12105/22649
url https://hdl.handle.net/20.500.12105/22649
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Arán Ediciones
publisher.none.fl_str_mv Arán Ediciones
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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