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https://www.readbyqxmd.com/read/28631218/an-observational-study-of-the-effect-of-levodopa-carbidopa-intestinal-gel-on-activities-of-daily-living-and-quality-of-life-in-advanced-parkinson-s-disease-patients
#1
Rejko Krüger, Paul Lingor, Triantafyllos Doskas, Johanna M L Henselmans, Erik H Danielsen, Oriol de Fabregues, Alessandro Stefani, Sven-Christian Sensken, Juan Carlos Parra, Koray Onuk, Ashley Yegin, Angelo Antonini
INTRODUCTION: Continuous delivery of levodopa-carbidopa intestinal gel (LCIG) by percutaneous endoscopic gastrojejunostomy (PEG-J) in advanced Parkinson's disease (PD) patients reduces variability in plasma levels, providing better control of motor fluctuations ("on" and "off" states). The MONOTREAT study assessed the effect of LCIG on activities of daily living, motor and non-motor symptoms, and quality of life in advanced PD patients. METHODS: This prospective, observational study included patients with advanced, levodopa-responsive PD with either 2-4 h of "off" time or 2 h of dyskinesia daily...
June 19, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28608472/peripheral-neuropathy-in-30-duodopa-patients-with-vitamins-b-supplementation
#2
V Rispoli, V Simioni, J G Capone, N Golfrè Andreasi, F Preda, E Sette, V Tugnoli, M Sensi
OBJECTIVES: Peripheral neuropathy (PN) is a significant concern and potential cause of withdrawal in patients with Parkinson's disease (PD) treated with Levodopa/Carbidopa Intestinal Gel (LCIG) infusion. Vitamin B deficiency and/or hyperhomocysteinemia levodopa-related are considered possible causative factors. In this study, we evaluated PN incidence in LCIG-PD patients treated since the beginning of infusion with vitamins B supplementation. MATERIALS & METHODS: In this prospective open-label pilot study, 30 consecutive patients with PD on LCIG infusion were evaluated with clinical, neurophysiological, and biochemical assessments for a mean follow-up of 42...
June 12, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28554418/device-aided-treatment-strategies-in-advanced-parkinson-s-disease
#3
Jonathan Timpka, Bianca Nitu, Veronika Datieva, Per Odin, Angelo Antonini
With peroral levodopa treatment, a majority of patients develop motor fluctuations and dyskinesia already within a few years of therapy. Device-aided Parkinson (PD) therapies refer to deep brain stimulation (DBS), levodopa-carbidopa intestinal gel infusion (LCIG), and subcutaneous infusion of the dopamine agonist apomorphine and represent effective strategies counteracting motor fluctuations and dyskinesia. These three therapy options seem to be similarly effective in reducing "time with PD symptoms (off time)" by at least 60%-65%...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28523235/effects-of-levodopa-carbidopa-intestinal-gel-versus-oral-levodopa-carbidopa-on-b-vitamin-levels-and-neuropathy
#4
Sebastian Loens, Elena Chorbadzhieva, Alexandra Kleimann, Dirk Dressler, Christoph Schrader
OBJECTIVES: To determine the possible interactions between levodopa therapy and plasma levels of B vitamins in patients with advanced idiopathic Parkinson's disease (IPD) in the context of either oral levodopa therapy or levodopa/carbidopa intestinal gel (LCIG). Secondly, to determine the prevalence of neuropathy and its relation to plasma levels of B vitamins and homocysteine. METHODS: Medication doses, neurographies, and serum levels of pyridoxine, cobalamin, folate, and homocysteine of eight LCIG and 13 orally treated advanced IPD patients matched for age, Hoehn & Yahr stage, and UPRDS III were collected...
May 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28424899/a-polysomnographic-study-in-parkinsonian-patients-treated-with-intestinal-levodopa-infusion
#5
Maurizio Zibetti, Alberto Romagnolo, Aristide Merola, Lorenzo Priano, Elisa Montanaro, Serena Angrisano, Antonella Tribolo, Alessandro Cicolin, Leonardo Lopiano
Sleep disorders are very common in advanced Parkinson's disease (PD) and have a significant negative impact on the quality of life of patients. Questionnaire-based studies suggest that sleep quality might improve following levodopa-carbidopa intestinal gel (LCIG) infusion. The objective of this study was to evaluate the impact of LCIG infusion and subsequent oral medication changes on polysomnography (PSG) and sleep symptoms in advanced PD patients. Eleven PD patients underwent PSG at baseline and after 3.8 ± 1...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28374689/-levodopa-carbidopa-intestinal-gel-in-the-treatment-of-patients-with-parkinson-disease-results-of-a-12-month-open-study
#6
A A Skoromets, M M Odinak, E Z Yakupov, I V Litvinenko, Z A Zalyalova, A A Timofeeva, S Yu Kirtaev, R R Bogdanov, A S Agafina, K Chatamra, W Robieson, J Benesh, G R Latypova, M V Ershova, S N Illarioshkin
AIM: To evaluate the long-term safety and efficacy of intrajejunal levodopa-carbidopa intestinal gel (LCIG) infusion in the treatment of patients with severe stages of Parkinson disease (PD) who did not respond adequately to treatment with oral drugs. MATERIAL AND METHODS: A large-scale international prospective open-label 54-week study of LCIG in patients with PD with severe motor fluctuations was carried out. A total of 48 patients were enrolled in Russia, 46 patients (95...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28344656/levodopa-carbidopa-enteral-suspension-in-advanced-parkinson-s-disease-clinical-evidence-and-experience
#7
REVIEW
Johan Virhammar, Dag Nyholm
The duration of action of oral levodopa becomes shorter as Parkinson's disease (PD) progresses. Patients with advanced PD may develop potentially disabling motor fluctuations and abnormal involuntary movement (dyskinesia), which cannot be managed with optimized oral or transdermal PD medications. The progressively worsening symptoms can have a substantial impact on the patient quality of life (QoL). Levodopa-carbidopa intestinal gel (LCIG) is delivered continuously via a percutaneous endoscopic gastrostomy with a jejunal extension (PEG-J)...
March 2017: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/28238650/which-patients-discontinue-issues-on-levodopa-carbidopa-intestinal-gel-treatment-italian-multicentre-survey-of-905-patients-with-long-term-follow-up
#8
MULTICENTER STUDY
Mariachiara Sensi, Giovanni Cossu, Francesca Mancini, Manuela Pilleri, Maurizio Zibetti, Nicola Modugno, Rocco Quatrale, Filippo Tamma, Angelo Antonini
OBJECTIVES: To report the results of a national survey aimed at quantifying the current level of diffusion of Levodopa/carbidopa intestinal gel (LCIG) in Italy. METHODS: Sixty Parkinson's Disease (PD) specialists in Italy were invited to complete a survey covering issues on clinical and practical aspects of LCIG therapy. RESULTS: Clinical features of 905 patients were collected retrospectively. The majority of centres reported the use of a multidisciplinary team, biochemistry testing, neurophysiological and neuropsychological tests before and after treatment, in addition to caregivers' training and patient's follow as outpatients...
May 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28229223/levodopa-carbidopa-intestinal-gel-lcig-infusion-as-mono-or-combination-therapy
#9
Carsten Buhmann, R Hilker, P Lingor, C Schrader, J Schwarz, M Wolz, H Reichmann
Levodopa/carbidopa intestinal gel (LCIG) infusion is an effective escalating therapy in patients with Parkinson disease (PD) suffering from motor fluctuations and dyskinesia. Levodopa/carbidopa given continuously as infusion provides an optimized application of the most effective and best tolerable antiparkinsonian drug. It has been proven to have a superior motor effect compared with oral levodopa and to improve also non-motor symptoms. However, invasiveness, discomfort resulting from carrying an external device, and side effects associated with the way of administration limit its application in PD patients...
February 22, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28211816/levodopa-carbidopa-intestinal-gel-pharmacokinetics-lower-variability-than-oral-levodopa-carbidopa
#10
Ahmed A Othman, Matthew Rosebraugh, Krai Chatamra, Charles Locke, Sandeep Dutta
In a double-blind, double-dummy, double-titration Phase 3 trial in advanced Parkinson's disease (PD) patients, the efficacy and safety of Levodopa-carbidopa intestinal gel (LCIG) infusion were characterized relative to immediate-release oral levodopa-carbidopa (LC-oral) treatment. We present in this report the comparative pharmacokinetic profiles of LCIG and LC-oral from this pivotal study. The results presented in this report clearly demonstrate that LCIG results in lower variability and fluctuations in levodopa and carbidopa plasma concentrations compared to LC-oral...
2017: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/28185758/levodopa-carbidopa-intestinal-gel-can-improve-both-motor-and-non-motor-experiences-of-daily-living-in-parkinson-s-disease-an-open-label-study
#11
Annamária Juhász, Zsuzsanna Aschermann, Péter Ács, József Janszky, Márton Kovács, Attila Makkos, Márk Harmat, Dalma Tényi, Kázmér Karádi, Sámuel Komoly, Annamária Takáts, Adrián Tóth, Helga Nagy, Péter Klivényi, György Dibó, Lívia Dézsi, Dénes Zádori, Ádám Annus, László Vécsei, Lajos Varannai, Norbert Kovács
BACKGROUND: Levodopa/carbidopa intestinal gel therapy (LCIG) can efficiently improve several motor and non-motor symptoms of advanced Parkinson's disease (PD). The recently developed Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) improved the original UPDRS making it a more robust tool to evaluate therapeutic changes. However, previous studies have not used the MDS-UPDRS and the Unified Dyskinesia Rating Scale (UDysRS) to assess the efficacy of LCIG...
February 3, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28063683/diphasic-dyskinesias-during-levodopa-carbidopa-intestinal-gel-lcig-infusion-in-parkinson-s-disease
#12
Mario Meloni, Paolo Solla, Marcello Mario Mascia, Francesco Marrosu, Antonino Cannas
OBJECTIVES: Levodopa-carbidopa intestinal gel infusion (LCIG) is indicated in patients with advanced levodopa-responsive Parkinson's disease (PD) for the treatment of motor fluctuations and dyskinesias. Here we describe 4 PD patients who developed disabling diphasic dyskinesias after LCIG initiation. METHODS: The clinical data of 33 PD patients consecutively treated with LCIG therapy were obtained through direct clinical observation and detailed review of medical records...
December 31, 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27998652/the-need-for-non-oral-therapy-in-parkinson-s-disease-a-potential-role-for-apomorphine
#13
Teus van Laar, Robbert Borgemeester
In the course of Parkinson's disease (PD), oral medication may lose its effectiveness due to several reasons, like dysphagia, impaired absorption from the gastro-intestinal tract and delayed emptying of the stomach. If these problems occur, a non-oral therapy should be considered. Examples of non-oral therapies are transdermal patches, (e.g. rotigotine) which may overcome motor and nonmotor nighttime problems, and may serve as well to treat daytime response-fluctuations, if oral therapies fail to do so. Other options are injections with apomorphine to treat early morning dystonia and random off-periods during daytime, as well as continuously infused subcutaneous apomorphine for random fluctuations in PD patients...
December 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27755134/the-effect-of-l-dopa-carbidopa-intestinal-gel-in-parkinson-disease-assessed-using-neurophysiologic-techniques
#14
Matteo Bologna, Anna Latorre, Francesca Di Biasio, Antonella Conte, Daniele Belvisi, Nicola Modugno, Antonio Suppa, Alfredo Berardelli, Giovanni Fabbrini
BACKGROUND: By providing a stable and smooth L-dopa plasmatic level, L-dopa/carbidopa intestinal gel reproduces the physiological continuous dopaminergic receptor stimulation in patients with Parkinson disease (PD), and it therefore represents a suitable tool to investigate the role of the altered dopaminergic neurotransmission in the pathophysiology of motor and sensory abnormalities in this condition. METHODS: We studied 11 patients with advanced PD being treated with L-Dopa/carbidopa intestinal gel (LCIG) and 11 age-matched healthy subjects...
November 2016: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/27743318/novel-levodopa-formulations-for-parkinson-s-disease
#15
REVIEW
Maria Eliza Freitas, Marta Ruiz-Lopez, Susan H Fox
Levodopa remains the most effective treatment for Parkinson's disease and is considered the gold standard therapy. However, disease progression and changes in the gastrointestinal tract result in a declining window of treatment response in a majority of patients. Efforts have been made recently to improve levodopa bioavailability either by developing more effective oral formulations or by innovating routes of administration (intestinal infusion, transcutaneous or inhaled levodopa). IPX066 is a novel levodopa-carbidopa (LD/CD) oral formulation combining immediate-release (IR) and extended-release (ER) LD/CD recently approved in the USA and the EU...
November 2016: CNS Drugs
https://www.readbyqxmd.com/read/27614656/weight-loss-and-decubitus-duodenal-ulcer-in-parkinson-s-disease-treated-with-levodopa-carbidopa-intestinal-gel-infusion
#16
Tommaso Martino, Donato Melchionda, Paolo Tonti, Vincenzo De Francesco, Alessandra Lalla, Luigi Maria Specchio, Carlo Avolio
Apparently, unexplained weight loss is a common symptom experienced by patients affected by Parkinson's disease, especially in those treated by levodopa-carbidopa infusion gel (LCIG) with a poor control of dyskinesias. Weight loss is considered part of gastrointestinal dysfunction seen in patients affected by Parkinson's disease, along with gastroparesis and reduced bowel peristalsis. In patients treated with LCIG, weight loss needs to be accurately evaluated, because of possible underlying life-threatening adverse events, like duodenum decubitus ulcer...
December 2016: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27514937/levodopa-carbidopa-intestinal-gel-therapy-for-advanced-parkinson-disease-an-early-toxic-effect-for-small-nerve-fibers
#17
Grazia Devigili, Sara Rinaldo, Christian Lettieri, Roberto Eleopra
INTRODUCTION: Peripheral neuropathy related to levodopa/carbidopa intestinal gel (LCIG) therapy for advanced Parkinson disease (PD) is under investigation and is debated in the literature. The purpose of the study was to detect whether small nerve fibers are damaged during LCIG infusion. METHODS: Five advanced PD patients were enrolled prior to starting LCIG infusion. Six PD patients on oral levodopa (LD) treatment and 6 PD patients naïve to LD were also enrolled...
August 12, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27440190/long-term-effectiveness-of-levodopa-carbidopa-intestinal-gel-in-177-spanish-patients-with-advanced-parkinson-s-disease
#18
Francesc Valldeoriola, Francisco Grandas, Diego Santos-García, Ignacio Regidor, María José Catalán, José Matías Arbelo, Víctor Puente, Pablo Mir, Juan Carlos Parra
AIM: To assess long-term effectiveness and tolerability of levodopa-carbidopa intestinal gel (LCIG) in Spanish patients with advanced Parkinson's disease. PATIENTS & METHODS: This was an observational, multicenter, cross-sectional, retrospective study. RESULTS: Data of 177 patients were analyzed. LCIG treatment led to a reduction in the percentage of daily 'off' time (16.2 vs 47.6% before LCIG), an increase in the percentage of daily 'on' time without disabling dyskinesia (55...
August 2016: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/27421834/motor-outcomes-in-patients-with-advanced-parkinson-s-disease-treated-with-levodopa-carbidopa-intestinal-gel-in-italy-an-interim-analysis-from-the-greenfield-observational-study
#19
Leonardo Lopiano, Nicola Modugno, Pietro Marano, Mariachiara Sensi, Giuseppe Meco, Antonino Cannas, Graziano Gusmaroli, Filippo Tamma, Francesca Mancini, Rocco Quatrale, Anna Maria Costanzo, Giuliana Gualberti, Gabriella Melzi, Umberto di Luzio Paparatti, Angelo Antonini
Several levodopa/carbidopa intestinal gel (LCIG) studies showed a significant reduction of OFF time and a significant increase of ON time, as well as a reduction of dyskinesia, and improvement of non-motor symptoms and quality of life. However, few studies have been conducted in a large population for more than 3 years. Interim outcomes from GREENFIELD observational study on a large Italian cohort of advanced PD patients who started LCIG in routine care between 2007 and 2014, still on treatment at the enrollment, are presented...
November 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27338069/continuous-intra-jejunal-infusion-of-levodopa-carbidopa-intestinal-gel-by-jejunal-extension-tube-placement-through-percutaneous-endoscopic-gastrostomy-for-patients-with-advanced-parkinson-s-disease-a-preliminary-study
#20
C Zulli, M Sica, R De Micco, A Del Prete, M R Amato, A Tessitore, F Ferraro, P Esposito
OBJECTIVE: Levodopa is the gold standard in the pharmacological treatment of Parkinson's disease (PD) and its oral administration is associated with the development of disabling motor and non-motor complications in advanced disease. Levodopa is rapidly metabolized and has a short plasma half-life thus requiring frequent, repeated dosing. Impaired gastric emptying is common in PD, and likely contributes to the unpredictable motor responses observed with orally-dosed levodopa. A new therapeutic protocol for patients with advanced PD include a carbidopa/levodopa combination using continuous, modulated enteral administration achieved inserting a Jejunal Extension Tube Placement through Percutaneous Endoscopic Gastrostomy (PEG-J)...
June 2016: European Review for Medical and Pharmacological Sciences
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