Read by QxMD icon Read


Katharina Maria Lex, Firuzan Sari Kundt, Stefan Lorenzl
The inability to achieve adequate nutrition and weight loss are serious problems for patients with advanced Parkinson's disease (PD). To ensure the optimal intake of nutrition and fluids and to administer levodopa-carbidopa intestinal gel (LCIG) (which patients need to increase or maintain their mobility as long as possible), different artificial feeding tubes can be used. Although percutaneous endoscopic gastrostomy (PEG) tubes are frequently used in medical practice, there is little research that addresses key questions, including if and when to administer artificial fluids, nutrition and/or LCIG via tubes...
March 8, 2018: British Journal of Nursing: BJN
Alessandro Tessitore, Pietro Marano, Nicola Modugno, Francesco E Pontieri, Nicola Tambasco, Margherita Canesi, Anna Latorre, Leonardo Lopiano, Mariachiara Sensi, Rocco Quatrale, Paolo Solla, Giovanni Defazio, Gabriella Melzi, Anna Maria Costanzo, Giuliana Gualberti, Umberto di Luzio Paparatti, Angelo Antonini
INTRODUCTION: Caring for a person with Parkinson's disease (PD) is associated with an increased risk of psychiatric morbidity and persistent distress. The objective of this study was to describe the burden and the related factors of caregivers of advanced PD (APD) patients either treated with continuous dopaminergic delivery systems or standard therapy. METHODS: This cross-sectional, epidemiologic study conducted in 13 Italian sites enrolled PD patients treated with continuous dopaminergic delivering systems [either levodopa/carbidopa intestinal gel (LCIG) infusion or continuous subcutaneous apomorphine infusion (CSAI)] or continuation of standard of care (SOC) with a caregiver...
March 7, 2018: Journal of Neurology
Miho Murata, Masahito Mihara, Kazuko Hasegawa, Beomseok Jeon, Chon-Haw Tsai, Noriko Nishikawa, Tomoko Oeda, Masayuki Yokoyama, Weining Z Robieson, Krai Chatamra, Maurizio F Facheris, Janet Benesh
Objectives: Levodopa-carbidopa intestinal gel (LCIG) was developed to reduce motor complications in Parkinson's disease (PD) caused by pulsatile levodopa plasma concentrations following oral levodopa administration. Dyskinesia and 'wearing off' symptoms can vary between Asian and Caucasian patients with PD, thus highlighting the importance of assessing the effectiveness of LCIG in an Asian population. Efficacy and safety of LCIG were previously assessed in a 12-week open-label study; we report the efficacy and safety of at least 52 weeks of LCIG treatment in Japanese, Taiwanese, and Korean patients with advanced PD in the ongoing extension study...
2018: Therapeutic Advances in Neurological Disorders
Maurizio Zibetti, Serena Angrisano, Francesca Dematteis, Carlo Alberto Artusi, Alberto Romagnolo, Aristide Merola, Leonardo Lopiano
OBJECTIVE: To determine the impact of levodopa-carbidopa intestinal gel (LCIG) infusion on different subtypes of freezing of gait (FoG) classified according to levodopa responsiveness in advanced Parkinson disease (PD) patients. METHODS: We retrospectively assessed the presence and severity of FoG in 32 advanced PD patients based on the Unified PD Rating Scale (UPDRS) item 14 score. Different FoG subtypes were inferred from the score variation with oral dopaminergic medications...
February 15, 2018: Journal of the Neurological Sciences
David G Standaert, James T Boyd, Per Odin, Weining Z Robieson, Jorge Zamudio, Krai Chatamra
Levodopa-carbidopa intestinal gel (LCIG, carbidopa-levodopa enteral suspension in the United States) is a treatment option for advanced Parkinson's disease (PD) patients with motor fluctuations. The objective of this investigation was to identify the baseline characteristics predictive of treatment response, measured by improvement in motor symptom severity, in advanced PD patients treated with LCIG during a 54-week, open-label phase 3 study. Patients with ≥1 h improvement from baseline in "Off" time were categorized as "Responders"; whereas those with <1 h improvement, any worsening, or no post-baseline assessment were "Non-Responders"...
2018: NPJ Parkinson's Disease
Maria José Catalán, Angelo Antonini, Matilde Calopa, Ovidiu Băjenaru, Oriol de Fábregues, Adolfo Mínguez-Castellanos, Per Odin, José Manuel García-Moreno, Stephen W Pedersen, Zvezdan Pirtošek, Jaime Kulisevsky
Advanced Parkinson's disease (APD) is characterized by increased functional disability, caused by motor complications, the presence of axial symptoms, and emergent disease- and drug-related non-motor symptoms. One of the advanced therapies available is intrajejunal infusion of levodopa/carbidopa intestinal gel (LCIG); however, patient selection for this treatment is sometimes difficult, particularly because of overlapping indications with other alternatives. In recent years, strong evidence has supported the use of LCIG in treating motor fluctuations associated with APD, and several clinical studies provide emerging evidence for additional benefits of LCIG treatment in certain patients...
September 2017: ENeurologicalSci
David G Standaert, Ramon L Rodriguez, John T Slevin, Michael Lobatz, Susan Eaton, Krai Chatamra, Maurizio F Facheris, Coleen Hall, Kavita Sail, Yash J Jalundhwala, Janet Benesh
Background: Levodopa-carbidopa intestinal gel (LCIG; carbidopa-levodopa enteral suspension in the United States), delivered via percutaneous gastrojejunostomy (PEG-J) and titrated in the inpatient setting, is an established treatment option for advanced Parkinson's disease (PD) patients with motor fluctuations. However, long-term prospective data on the efficacy of LCIG on non-motor symptoms and the safety of outpatient titration are limited. Methods: In this 60-week, open-label phase 3b study, LCIG titration was initiated in an outpatient setting following PEG-J placement in PD patients...
November 2017: Movement Disorders Clinical Practice
Francesc Valldeoriola, Pilar Santacruz, José Ríos, Yaroslau Compta, Jordi Rumià, José Esteban Muñoz, María José Martí, Eduardo Tolosa
Objective: In Parkinson's disease (PD), effects on behavior and cognition of levodopa/carbidopa intestinal gel (LCIG) and subthalamic stimulation (STN-DBS) and their practical consequences remain controversial. This study was designed to analyze the possible effects of these therapies on cognition and behavior after 1 year follow-up. Methods: This was an open-label, nonrandomized prospective study for pre- and postintervention analyses. Twenty-four patients were considered eligible to be candidates for complex therapies such as STN-DBS or LCIG; 23 patients treated with standard medication were included as controls...
November 2017: Brain and Behavior
Angelo Antonini, Werner Poewe, K Ray Chaudhuri, Robert Jech, Barbara Pickut, Zvezdan Pirtošek, Jozsef Szasz, Francesc Valldeoriola, Christian Winkler, Lars Bergmann, Ashley Yegin, Koray Onuk, David Barch, Per Odin
INTRODUCTION: This registry evaluated the 24-month safety and efficacy of levodopa-carbidopa intestinal gel (LCIG) treatment in advanced Parkinson's disease (PD) patients under routine clinical care. METHODS: Motor fluctuations, dyskinesia, non-motor symptoms, quality of life, and safety were evaluated. Observations were fully prospective for treatment-naïve patients (60% of patients) and partially retrospective for patients with ≤12 months of pre-treatment with LCIG (40% of patients)...
September 22, 2017: Parkinsonism & related Disorders
Thomas Willows, Nil Dizdar, Dag Nyholm, Håkan Widner, Peter Grenholm, Ursula Schmiauke, Anna Urbom, Kristina Groth, Jörgen Larsson, Johan Permert, Susanna Kjellander
BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG; Duodopa®) is used for continuous infusion in advanced Parkinson's disease. To achieve optimal effect, the LCIG dose is individually titrated, traditionally conducted during hospitalization in Sweden. However, dose adjustment depends on surrounding conditions, physical activity, and emotional stress, which is why titration at home could be beneficial. Telemedicine (TM) using a video communication system offers alternative titration procedures, allowing LCIG initiation at home...
2017: Journal of Parkinson's Disease
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 and 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...
November 2017: Journal of Medical Economics
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
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
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
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
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...
October 2017: Neurological Sciences
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
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
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
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
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"