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Levodopa/carbidopa intestinal gel

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https://www.readbyqxmd.com/read/27859651/sustained-striatal-dopamine-levels-following-intestinal-levodopa-infusions-in-parkinson-s-disease-patients
#1
Marios Politis, Anna Sauerbier, Clare Loane, Nicola Pavese, Anne Martin, Benjamin Corcoran, David J Brooks, K Ray-Chaudhuri, Paola Piccini
BACKGROUND: The objective of this study was to investigate in vivo the ability of levodopa/carbidopa intestinal gel infusions to produce sustained striatal dopamine levels and to improve clinical outcomes in Parkinson's disease patients. METHODS: Six advanced Parkinson's disease patients had serial [(11) C]raclopride PET to assess levodopa/carbidopa intestinal gel infusion-induced rises in striatal dopamine as reflected by a fall in dopamine-D2/3 receptor availability...
November 17, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/27743318/novel-levodopa-formulations-for-parkinson-s-disease
#2
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...
October 14, 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
#3
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/27575745/corrigendum-to-global-long-term-study-on-motor-and-non-motor-symptoms-and-safety-of-levodopa-carbidopa-intestinal-gel-in-routine-care-of-advanced-parkinson-s-disease-patients-12-month-interim-outcomes-parkinsonism-relat-disord-21-3-2015-231-235
#4
Angelo Antonini, Ashley Yegin, Cornelia Preda, Lars Bergmann, Werner Poewe
No abstract text is available yet for this article.
October 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27514937/levodopa-carbidopa-intestinal-gel-therapy-for-advanced-parkinson-disease-an-early-toxic-effect-for-small-nerve-fibers
#5
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/27495198/treating-the-motor-symptoms-of-parkinson-disease
#6
John C Morgan, Susan H Fox
PURPOSE OF REVIEW: After a patient is diagnosed with Parkinson disease (PD), there are many therapeutic options available. This article provides examples of prototypical patients encountered in clinical practice and illustrates the various pharmacologic and nonpharmacologic treatment options for the motor symptoms of PD. RECENT FINDINGS: Levodopa became available in the late 1960s and remains the gold standard for the treatment of PD even today. Since that time, amantadine, monoamine oxidase type B inhibitors, dopamine agonists, and catechol-O-methyltransferase inhibitors have emerged as monotherapy, add-on therapies, or both, in the armamentarium against PD...
August 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27472888/choosing-an-advanced-therapy-in%C3%A2-parkinson-s-disease-is%C3%A2-it%C3%A2-an%C3%A2-evidence-based-decision-in%C3%A2-current%C3%A2-practice
#7
Frouke A P Nijhuis, Jolien van Heek, Bastiaan R Bloem, Bart Post, Marjan J Faber
BACKGROUND: In advanced Parkinson's disease (PD), neurologists and patients face a complex decision for an advanced therapy. When choosing a treatment, the best available evidence should be combined with the professional's expertise and the patient's preferences. OBJECTIVE: The objective of this study was to explore current decision-making in advanced PD. METHODS: We conducted focus group discussions and individual interviews with patients (N = 20) who had received deep brain stimulation, Levodopa-Carbidopa intestinal gel, or subcutaneous apomorphine infusion, and with their caregivers (N = 16)...
July 25, 2016: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/27440190/long-term-effectiveness-of-levodopa-carbidopa-intestinal-gel-in-177-spanish-patients-with-advanced-parkinson-s-disease
#8
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
#9
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...
July 15, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27392872/wearable-sensors-for-advanced-therapy-referral-in-parkinson-s-disease
#10
Dustin A Heldman, Joseph P Giuffrida, Esther Cubo
BACKGROUND: Advanced therapies, such as deep brain stimulation and levodopa-carbidopa intestinal gel, can significantly improve quality of life in advanced Parkinson's disease (PD). However, determining who should be referred for advanced therapy is a challenging problem. OBJECTIVE: The objective was to determine the impact of remote monitoring using objective, wearable sensors on the advanced therapy referral rate in patients with advanced PD and if sensor data differed in patients who were referred and those who were not...
July 2, 2016: Journal of Parkinson's Disease
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
#11
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
https://www.readbyqxmd.com/read/27318707/levodopa-carbidopa-intestinal-gel-lcig-treatment-in-routine-care-of-patients-with-advanced-parkinson-s-disease-an-open-label-prospective-observational-study-of-effectiveness-tolerability-and-healthcare-costs
#12
Sven E Pålhagen, Olof Sydow, Anders Johansson, Dag Nyholm, Bjorn Holmberg, Hakan Widner, Nil Dizdar, Jan Linder, Tove Hauge, Rasmus Jansson, Lars Bergmann, Susanna Kjellander, Thomas S Marshall
BACKGROUND: Continuous infusion of levodopa-carbidopa intestinal gel (LCIG) can effectively manage motor and non-motor complications in advanced Parkinson's disease (PD). Healthcare costs, quality of life (QoL), effectiveness, and tolerability were assessed in routine care treatment with LCIG. METHODS: The seventy-seven patients enrolled in this prospective, open-label, 3-year study in routine medical care were LCIG-naïve (N = 37), or had previous LCIG treatment for <2 (N = 22), or ≥2 (N = 18) years...
August 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27215392/advanced-therapies-in-parkinson-s-disease-long-term-retrospective-study
#13
Aristide Merola, Alberto J Espay, Alberto Romagnolo, Andrea Bernardini, Laura Rizzi, Michela Rosso, Kristy J Espay, Maurizio Zibetti, Michele Lanotte, Leonardo Lopiano
BACKGROUND: Levodopa/carbidopa intestinal gel infusion (LCIG) and subthalamic nucleus deep brain stimulation (STN-DBS) are approved therapies for advanced Parkinson's disease (PD) whose long-term comparability remains unclear. METHODS: We reviewed the 5-year data on activities of daily living (ADL) and motor complications (OFF time, dyskinesia duration, and dyskinesia severity), as measured by the Unified Parkinson Disease Rating Scale (UPDRS) section-II and section-IV (items 39, 32, and 33, respectively) in 60 PD patients exposed to STN-DBS (n = 20), LCIG (n = 20), and oral medical therapy (OMT) (n = 20) at similar baseline disability and cognitive state...
August 2016: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/27138916/levodopa-carbidopa-intestinal-gel-in-patients-with-parkinson-s-disease-a-systematic-review
#14
REVIEW
Karin Wirdefeldt, Per Odin, Dag Nyholm
BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is available in several countries for the treatment of advanced levodopa-responsive Parkinson's disease (PD) with severe motor fluctuations and dyskinesia when other treatments have not given satisfactory results. OBJECTIVE: Our objective was to summarize the present evidence base for LCIG therapy through a systematic review of the literature. METHODS: Studies were identified from the PubMed and EMBASE databases up to 12 March 2016 using the following search terms: Parkinson disease, duodopa, levodopa/carbidopa intestinal gel, levodopa-carbidopa intestinal gel, LCIG, l-dopa infusion, levodopa infusion, duodenal l-dopa infusion, and duodenal levodopa infusion...
May 2016: CNS Drugs
https://www.readbyqxmd.com/read/27075968/clinical-management-of-patients-with-advanced-parkinson-s-disease-treated-with-continuous-intestinal-infusion-of-levodopa-carbidopa
#15
Diego Santos García, Juan Carlos Martínez Castrillo, Víctor Puente Périz, Agustín Seoane Urgorri, Servando Fernández Díez, Vicente Benita León, Beatriz Udaeta Baldivieso, Antonia Campolongo Perillo, Natividad Mariscal Pérez
Patients with Parkinson's disease often have a good initial response to dopaminergic therapy but later usually develop motor fluctuations and dyskinesia. In these patients, continuous infusion of levodopa-carbidopa intestinal gel (LCIG) allows for maintaining adequate dopamine levels and for improving motor and nonmotor symptoms, as well as quality of life and autonomy. Adequate candidate selection and follow-up are crucial for treatment success. Management should be multidisciplinary, and patient and caregiver education is a priority...
June 2016: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/27030949/long-term-peg-j-tube-safety-in-patients-with-advanced-parkinson-s-disease
#16
Michael Epstein, David A Johnson, Robert Hawes, Nathan Schmulewitz, Arvydas D Vanagunas, E Roderich Gossen, Weining Z Robieson, Susan Eaton, Jordan Dubow, Krai Chatamra, Janet Benesh
OBJECTIVES: The objectives of this study were to present procedure- and device-associated adverse events (AEs) identified with long-term drug delivery via percutaneous endoscopic gastrojejunostomy (PEG-J). Levodopa-carbidopa intestinal gel (LCIG, also known in US as carbidopa-levodopa enteral suspension, CLES) is continuously infused directly to the proximal small intestine via PEG-J in patients with advanced Parkinson's disease (PD) to overcome slow and erratic gastric emptying and treat motor fluctuations that are not adequately controlled by oral or other pharmacological therapy...
2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27000142/prospective-study-on-cost-effectiveness-of-home-based-motor-assessment-in-parkinson-s-disease
#17
E Cubo, N Mariscal, B Solano, V Becerra, D Armesto, S Calvo, J Arribas, J Seco, A Martinez, L Zorrilla, D Heldman
INTRODUCTION: Treatment adjustments in Parkinson's disease (PD) are in part dependent on motor assessments. The aim of this study was to evaluate the cost-effectiveness of home-based motor monitoring plus standard in-office visits versus in-office visits alone in patients with advanced PD. METHODS: The procedures consisted of a prospective, one-year follow-up, randomized, case-control study. A total of 40 patients with advanced PD were randomized into two groups: 20 patients underwent home-based motor monitoring by using wireless motion sensor technology, while the other 20 patients had in-office visits...
March 21, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/26946221/24-hour-infusion-of-levodopa-carbidopa-intestinal-gel-for-nocturnal-akinesia-in-advanced-parkinson-s-disease
#18
LETTER
Lucia Ricciardi, Francesco Bove, Kristy J Espay, Francesco Lena, Nicola Modugno, Yu-Yan Poon, Robert Krikorian, Alberto J Espay, Alfonso Fasano
No abstract text is available yet for this article.
April 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/26817533/effect-of-levodopa-carbidopa-intestinal-gel-on-dyskinesia-in-advanced-parkinson-s-disease-patients
#19
Angelo Antonini, Victor S C Fung, James T Boyd, John T Slevin, Coleen Hall, Krai Chatamra, Susan Eaton, Janet A Benesh
OBJECTIVE: The purpose of this study was to assess the effect of levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension) in advanced Parkinson's disease patients with troublesome dyskinesia. METHODS: Post hoc analyses of patient data from a 12-week, randomized, double-blind study and a 54-week open-label study were performed. Efficacy was assessed in the subgroup of patients defined by ≥1 hour of "on" time with troublesome dyskinesia at baseline as recorded in Parkinson's disease symptom diaries (double blind: n = 11 levodopa-carbidopa intestinal gel, n = 12 oral levodopa-carbidopa; open label: n = 144 levodopa-carbidopa intestinal gel)...
April 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/26777085/intraduodenal-levodopa-carbidopa-intestinal-gel-infusion-improves-both-motor-performance-and-quality-of-life-in-advanced-parkinson-s-disease
#20
Florence C F Chang, Vu Kwan, David van der Poorten, Neil Mahant, Nigel Wolfe, Ainhi D Ha, Jane M Griffith, David Tsui, Samuel D Kim, Victor S C Fung
We report the efficacy and adverse effect profile of intraduodenal levodopa-carbidopa intestinal gel (LCIG) infusion from patients treated in a single Australian movement disorder centre. We conducted an open-label, 12 month prospective study of treatment with LCIG in patients with advanced Parkinson's disease in a single tertiary referral hospital unit specialising in movement disorders. Patients with levodopa-responsive, advanced Parkinson's disease with motor fluctuations despite optimal pharmacological treatment were enrolled and underwent a 16 hour daily infusion of LCIG for 12 months...
March 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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