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https://www.readbyqxmd.com/read/28895769/the-cost-effectiveness-of-levodopa-carbidopa-intestinal-gel-compared-to-standard-care-in-advanced-parkinson-s-disease
#1
Julia Lowin, Kavita Sail, Rakhi Baj, Yash J Jalundhwala, Thomas S Marshall, Henrietta Konwea, K R Chaudhuri
BACKGROUND: Parkinson's disease (PD) is an incurable, progressive neurological condition, with symptoms impacting movement, walking and posture that eventually become severely disabling. Advanced PD (aPD) has a significant impact on quality of life (QoL) for patients, their caregivers/families. Levodopa/carbidopa intestinal gel (LCIG) is indicated for the treatment of advanced levodopa-responsive PD with severe motor fluctuations and hyper-/dyskinesia when available combinations of therapy have not given satisfactory results...
September 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28845835/continuous-dopaminergic-stimulation-in-a-patient-treated-with-daytime-levodopa-carbidopa-intestinal-gel-and-overnight-rotigotine-a-case-report
#2
Paola Imbriani, Tommaso Schirinzi, Alessio D'Elia, Antonio Pisani
Patients with Parkinson's disease (PD) receiving long-term L-Dopa therapy eventually develop motor complications with unpredictable "on-off" response fluctuations and involuntary movements, leading to progressive disability. Hence, the search for alternative therapeutic choices based on continuous dopaminergic stimulation (CDS) becomes crucial for the treatment of advanced PD. Here, we describe the case of a 70-year-old man with a 9-year history of PD, treated with daytime levodopa-carbidopa intestinal gel (LCIG) and overnight Rotigotine transdermal patch...
August 23, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28828219/long-term-safety-and-effectiveness-of-levodopa-carbidopa-intestinal-gel-infusion
#3
Oriol De Fabregues, Joan Dot, Monder Abu-Suboh, Jorge Hernández-Vara, Alex Ferré, Odile Romero, Marta Ibarria, José Luis Seoane, Nuria Raguer, Carolina Puiggros, Maria Rosa Gómez, Manuel Quintana, Josep Ramon Armengol, José Alvarez-Sabín
INTRODUCTION: Levodopa-carbidopa intestinal gel (LCIG) infusion has demonstrated to improve motor fluctuations. The aim of this study is to assess the long-term safety and effectiveness of LCIG infusion in advanced Parkinson's disease (PD) patients with motor fluctuations and its effect in nonmotor symptoms. METHODS: Adverse events (AE) and their management, clinical motor, and nonmotor aspects were assessed up to 10 years. Thirty-seven patients were treated with LGIC; 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...
August 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28805563/infusional-therapies-continuous-dopaminergic-stimulation-and-nonmotor-symptoms
#4
Ulrika Mundt-Petersen, Per Odin
Pump-based Parkinson (PD) therapies, including subcutaneous apomorphine infusion (CSA) and levodopa-carbidopa intestinal gel (LCIG), presently constitute the most effective pharmacological treatments available for advanced PD. These therapies are based on a more constant delivery of the dopaminergic drug resulting in a more continuous dopaminergic stimulation and a more stable treatment effect. This can be detected as reduction of time in off, reduction of dyskinesia frequency and severity, as well as increase of time in on without troublesome dyskinesias...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28729942/problems-related-to-levodopa-carbidopa-intestinal-gel-treatment-in-advanced-parkinson-s-disease
#5
Marianne Udd, Jukka Lyytinen, Johanna Eerola-Rautio, Anu Kenttämies, Outi Lindström, Leena Kylänpää, Eero Pekkonen
BACKGROUND: Continuous levodopa-carbidopa intestinal gel (LCIG) diminishes daily "off" time and dyskinesia in patients with advanced Parkinson's disease (PD). Complications are common with percutaneous endoscopic gastrostomy with a jejunal extension tube (PEG-J). AIM OF THE STUDY: To report the clinical outcome of LCIG in patients with advanced PD in the years 2006-2014 at Helsinki University Hospital. PATIENTS AND METHODS: Levodopa-carbidopa intestinal gel treatment started following PEG-J placement in patients with advanced PD after successful in-hospital LCIG trial with a nasojejunal tube...
July 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28642996/central-conduction-abnormalities-in-patients-receiving-levodopa-carbidopa-intestinal-gel-infusion
#6
Francesco Bove, Marco Luigetti, Lara Gallicchio, Valentina Recchia, Antonella Petruzzellis, Riccardo Di Iorio, Filippo Tamma, Alfonso Fasano
In recent years, several studies have reported a relatively high frequency of polyneuropathy in patients with Parkinson's disease (PD), in particular, in patients receiving levodopa-carbidopa intestinal gel (LCIG) infusion. In spite of the several patients investigated with nerve conduction studies, no study has prospectively explored a possible central nervous system involvement of patients receiving LCIG infusion. We prospectively evaluated eight PD patients receiving LCIG infusion, who underwent neurophysiological evaluations with nerve conduction studies, visual, somatosensory and motor evoked potentials before LCIG infusion, and 1 and 6 months after...
June 22, 2017: Neurological Sciences
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
#7
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...
July 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28608472/peripheral-neuropathy-in-30-duodopa-patients-with-vitamins-b-supplementation
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
April 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28063683/diphasic-dyskinesias-during-levodopa-carbidopa-intestinal-gel-lcig-infusion-in-parkinson-s-disease
#18
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
#19
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
#20
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
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