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Levodopa/carbidopa intestinal gel

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https://www.readbyqxmd.com/read/28642996/central-conduction-abnormalities-in-patients-receiving-levodopa-carbidopa-intestinal-gel-infusion
#1
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
#2
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
#3
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
#4
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
#5
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/28452905/duodenal-levodopa-infusion-for-long-term-deep-brain-stimulation-refractory-symptoms-in-advanced-parkinson-disease
#6
Ignacio Regidor, Vicente Benita, Marta Del Álamo de Pedro, Luis Ley, Juan Carlos Martinez Castrillo
OBJECTIVES: This study assesses the effect of levodopa/carbidopa intestinal infusion gel (LCIIG) as an additional treatment in patients with advanced idiopathic Parkinson disease (PD) previously treated with deep brain stimulation (DBS). METHODS: Prospective study of advanced PD patients, satisfactorily treated with bilateral DBS of the subthalamic nucleus, who had developed refractory symptoms and LCIIG was added. Controls were advanced PD patients treated with LCIIG...
May 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28424899/a-polysomnographic-study-in-parkinsonian-patients-treated-with-intestinal-levodopa-infusion
#7
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
#8
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
#9
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/28276779/development-of-new-levodopa-treatment-strategies-in-parkinson-s-disease-from-bedside-to-bench-to-bedside
#10
Sten-Magnus Aquilonius, Dag Nyholm
This review will illustrate the process of moving from an idea through preclinical research and Galenic developments into clinical investigations and finally to approval by regulatory agencies within the European Union. The two new treatment strategies described, levodopa/carbidopa intestinal gel and levodopa/carbidopa microtablets, for advanced Parkinson's disease, have been developed in collaborative research within departments at Uppsala University. With this historical approach, reference priority is given to reports considered to be of special importance for this more than two decades long process 'from bedside to bench to bedside'...
June 2017: Upsala Journal of Medical Sciences
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
#11
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
#12
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
#13
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/28195385/practical-approaches-to-commencing-device-assisted-therapies-for-parkinson-s-disease-in-australia
#14
REVIEW
D R Williams, A H Evans, V S C Fung, M Hayes, R Iansek, T Kimber, J D O'Sullivan, C M Sue
BACKGROUND: In Australia 1% of individuals aged over 50 years have Parkinson's disease (PD). AIMS: Guidance for commencing device-assisted therapies (DATs) for PD in Australia was developed based on a review of European recommendations and their relevance to the local clinical setting. METHODS: An online survey and teleconference discussions were held by a group of eight local movement disorder experts to develop consensus. RESULTS: Referral to a movement disorder specialist and consideration of DAT is appropriate when motor fluctuations cause disability or reduced quality of life, response to treatment is inconsistent or motor fluctuations and dyskinesias require frequent treatment adjustment without apparent benefit and levodopa is required four or more times daily...
February 14, 2017: Internal Medicine Journal
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
#15
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/28115853/the-role-and-structure-of-the-multidisciplinary-team-in-the-management-of-advanced-parkinson-s-disease-with-a-focus-on-the-use-of-levodopa-carbidopa-intestinal-gel
#16
REVIEW
Stephen W Pedersen, Martin Suedmeyer, Louis W C Liu, Dirk Domagk, Alison Forbes, Lars Bergmann, Koray Onuk, Ashley Yegin, Teus van Laar
A multidisciplinary team (MDT) approach is increasingly recommended in Parkinson's disease (PD) treatment guidelines, but no standard of care exists for such an approach, and the guidelines do not provide clarification on how it should be implemented. This paper reviews evidence of MDT interventions in people with PD and provides expert clinical perspectives for an MDT approach, with a focus on advanced PD and levodopa-carbidopa intestinal gel (carbidopa-levodopa enteral suspension in the USA). The key recommendations are to enable the best possible treatment of people with PD locally by facilitating a close structured collaboration of different health care professionals working in a fixed network structure; to refer people with PD to established MDT centers in a timely manner; to establish regular meetings for the MDT enabling interdisciplinary exchange and learning; to optimize individual treatment and carefully evaluate available treatment options; to ensure treatment decisions are agreed jointly between people with PD, their caregivers, family, and health care professional; and to include specialists outside of neurology from adjuvant medical departments as necessary when implementing advanced therapies...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28063683/diphasic-dyskinesias-during-levodopa-carbidopa-intestinal-gel-lcig-infusion-in-parkinson-s-disease
#17
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
#18
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/27987231/levodopa-entacapone-carbidopa-intestinal-gel-in-parkinson-s-disease-a-randomized-crossover-study
#19
Marina Senek, Elisabet I Nielsen, Dag Nyholm
BACKGROUND: The addition of oral entacapone to levodopa-carbidopa intestinal gel treatment leads to less conversion of levodopa to 3-O-methyldopa, thereby increasing levodopa plasma concentration. The objective of this study was to compare systemic levodopa exposure of the newly developed levodopa-entacapone-carbidopa intestinal gel after a 20% dose reduction with levodopa exposure after the usual levodopa-carbidopa intestinal gel dose in a randomized crossover trial in advanced Parkinson's disease patients...
February 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/27859651/sustained-striatal-dopamine-levels-following-intestinal-levodopa-infusions-in-parkinson-s-disease-patients
#20
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...
February 2017: Movement Disorders: Official Journal of the Movement Disorder Society
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