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Levodopa/carbidopa intestinal gel

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https://www.readbyqxmd.com/read/29701432/-advanced-parkinson-s-disease-indication-for-complex-treatments
#1
Matthieu Béreau, Emilie Tomkova, André Zacharia, Walid Bouthour, Vanessa Fleury, Julien François Bally, Judit Horvath, Shahan Momjian, Christian Lüscher, Pierre Burkhard, Paul Krack
Advanced Parkinson's disease (PD) is characterized by severe motor and non-motor complications that negatively impact on patients' autonomy and health-related quality of life. In early disease, the therapeutic strategy consists of gradual increase in dopaminergic treatment and levodopa dose fragmentation. In more advanced stages, this approach becomes insufficient and three therapeutic options can be considered: deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion, and continuous levodopa/carbidopa intestinal gel infusion...
April 25, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29623993/levodopa-carbidopa-intestinal-gel-dismantling-the-road-blocks-of-a-journey
#2
Nirosen Vijiaratnam, Carolyn M Sue
Levodopa-carbidopa intestinal gel offers superior treatment to standard oral therapy in selective patients with advanced Parkinson disease. The costs involved in instituting and maintaining this treatment are high but largely mitigated with the quality of life years the treatment offers. Key to this is ensuring a high retention rate once the treatment is instituted. We outline factors and considerations from our experience and viewpoints at each stage of the process to address in this 'journey' patients undertake that can help maximise retention rates and benefits...
April 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29623988/levodopa-carbidopa-intestinal-gel-is-the-naso-jejunal-phase-a-redundant-convention
#3
Nirosen Vijiaratnam, Sarah Hewer, Sue Varley, Eldho Paul, Kelly L Bertram, Will Lee, Matthew Ligtermoet, David R Williams
Levodopa-carbidopa intestinal gel (LCIG) is an effective treatment for Parkinson disease. Initiating therapy involves an initial naso-jejunal (NJ) titration phase. The NJ phase is prolonged with significant morbidity. The aim of this study is to assess the impact of proceeding without the NJ phase on resource utilisation and the outcomes of patients. Twenty-five patients were started on LCIG using the patients existing levodopa equivalent dose (LED). We recorded change in LED, length of hospital stay, readmission rates and use of outpatient services and clinical outcomes within 6 months...
April 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29570862/medical-and-surgical-management-of-advanced-parkinson-s-disease
#4
REVIEW
Angelo Antonini, Elena Moro, Clecio Godeiro, Heinz Reichmann
Advanced Parkinson's disease is characterized by the presence of motor fluctuations, various degree of dyskinesia, and disability with functional impact on activities of daily living and independence. Therapeutic management aims to extend levodopa benefit while minimizing motor complications and includes, in selected cases, the implementation of drug infusion and surgical techniques. In milder forms of motor complications, these can often be controlled with manipulation of levodopa dose and the introduction of supplemental therapies such as catechol-O-methyl transferase inhibitors, monoamine oxidase B inhibitors, and dopamine agonists including apomorphine...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29570853/long-term-safety-and-efficacy-of-levodopa-carbidopa-intestinal-gel-in-advanced-parkinson-s-disease
#5
Hubert H Fernandez, James T Boyd, Victor S C Fung, Mark F Lew, Ramon L Rodriguez, John T Slevin, David G Standaert, Cindy Zadikoff, Arvydas D Vanagunas, Krai Chatamra, Susan Eaton, Maurizio F Facheris, Coleen Hall, Weining Z Robieson, Janet Benesh, Alberto J Espay
BACKGROUND: Levodopa-carbidopa intestinal gel (designated as carbidopa-levodopa enteral suspension in the United States) provides stable plasma levodopa concentrations and reduces motor fluctuations in advanced Parkinson's disease patients through continuous delivery of levodopa via percutaneous endoscopic gastrojejunostomy. We report long-term safety and efficacy outcomes from an open-label phase 3 treatment program. METHODS: PD patients (n = 262) who completed a 12-week double-blind study and its 52-week open-label extension or a separate 54-week open-label study were enrolled in this ongoing phase 3 open-label, multinational study (NCT00660673)...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29569237/workforce-participation-and-activities-in-parkinson-s-disease-patients-receiving-device-aided-therapy
#6
T Sahlström, M Eklund, J Timpka, T Henriksen, D Nyholm, P Odin
OBJECTIVES: Many countries have an aging population, and it is thus likely that Parkinson's disease (PD) will become an increasing health problem. It is important to ensure this group can use their resources in the best way possible, including remaining in the work market. This study aimed to investigate workforce participation and daily activities among patients with PD receiving device-aided therapy to provide new knowledge that may be used to inform decisions about these therapy options...
March 22, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29557989/improvement-of-impulse-control-disorders-associated-with-levodopa-carbidopa-intestinal-gel-treatment-in-advanced-parkinson-s-disease
#7
Maria Jose Catalan, Jose Antonio Molina-Arjona, Pablo Mir, Esther Cubo, Jose Matias Arbelo, Pablo Martinez-Martin
Impulse control behaviors are a frequent comorbidity for patients with Parkinson's disease (PD). The objective of the present study was to evaluate the effectiveness levodopa-carbidopa intestinal gel (LCIG) therapy on impulse control disorders (ICDs) in patients with advanced PD. We conducted a multicenter, observational, and prospective (6 months follow-up) study that included consecutive PD patients assigned to LCIG through routine medical practice. Patients completed visits at baseline, 1, 3, and 6 months after percutaneous endoscopic gastrostomy procedure...
March 20, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29517331/using-tube-feeding-and-levodopa-carbidopa-intestinal-gel-application-in-advanced-parkinson-s-disease
#8
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
https://www.readbyqxmd.com/read/29516169/caregiver-burden-and-its-related-factors-in-advanced-parkinson-s-disease-data-from-the-predict-study
#9
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...
May 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29511383/safety-and-efficacy-of-levodopa-carbidopa-intestinal-gel-results-from-an-open-label-extension-study-in-japanese-korean-and-taiwanese-patients-with-advanced-parkinson-s-disease
#10
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
https://www.readbyqxmd.com/read/29406886/effects-of-intestinal-levodopa-infusion-on-freezing-of-gait-in-parkinson-disease
#11
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
https://www.readbyqxmd.com/read/29387783/systematic-evaluation-of-levodopa-carbidopa-intestinal-gel-patient-responder-characteristics
#12
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
https://www.readbyqxmd.com/read/29260038/can-suitable-candidates-for-levodopa-carbidopa-intestinal-gel-therapy-be-identified-using-current-evidence
#13
REVIEW
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
https://www.readbyqxmd.com/read/29242809/effect-of-levodopa-carbidopa-intestinal-gel-on-non-motor-symptoms-in-patients-with-advanced-parkinson-s-disease
#14
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
https://www.readbyqxmd.com/read/29201549/l-dopa-carbidopa-intestinal-gel-and-subthalamic-nucleus-stimulation-effects-on-cognition-and-behavior
#15
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
https://www.readbyqxmd.com/read/29037498/levodopa-carbidopa-intestinal-gel-in-advanced-parkinson-s-final-results-of-the-gloria-registry
#16
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)...
December 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28984615/initiation-of-levodopa-carbidopa-intestinal%C3%A2-gel-infusion-using-telemedicine-video-communication-system-facilitates-efficient-and-well-accepted-home-titration%C3%A2-in-patients-with-advanced-parkinson-s-disease
#17
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
https://www.readbyqxmd.com/read/28895769/the-cost-effectiveness-of-levodopa-carbidopa-intestinal-gel-compared-to-standard-care-in-advanced-parkinson-s-disease
#18
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
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
#19
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
#20
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
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