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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

Pålhagen, Sven E. LU ; Sydow, Olof; Johansson, Anders; Nyholm, Dag; Holmberg, Bjorn; Widner, Håkan LU ; Dizdar, Nil; Linder, Jan; Hauge, Tove and Jansson, Rasmus, et al. (2016) In Parkinsonism and Related Disorders 29. p.17-23
Abstract

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. Healthcare costs were collected monthly. PD symptoms and QoL were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), and EuroQoL 5-Dimension Visual Analog Scale (EQ-5D... (More)

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. Healthcare costs were collected monthly. PD symptoms and QoL were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), and EuroQoL 5-Dimension Visual Analog Scale (EQ-5D VAS); LCIG dose, safety, and tolerability were monitored. Results Mean monthly costs per patient (€8226 ± 5952) were similar across cohorts, remained steady during 3-year follow-up, and increased with PD severity and QoL impairment. In LCIG-naïve patients, significant improvements compared to baseline were observed on the UPDRS total score and PDQ-39 summary index score through 18 months (n = 24; UPDRS, p = 0.033; PDQ-39, p = 0.049). Symptom control was maintained during 3-year follow-up in LCIG-experienced cohorts. Small changes in mean daily LCIG dose were observed. Adverse events were common and generally related to the device, procedure, levodopa, or laboratory evaluations. Conclusions Costs in LCIG-treated patients were stable over 3 years. LCIG treatment led to significant improvements in motor function and QoL over 18 months in LCIG-naïve patients and no worsening was observed in LCIG-experienced patients over 3 years despite natural PD progression over time. The long-term safety was consistent with the established LCIG profile.

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Contribution to journal
publication status
published
subject
keywords
Cost, Infusion, LCIG, Levodopa, Parkinson's disease
in
Parkinsonism and Related Disorders
volume
29
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:84990876480
  • wos:000381955700004
ISSN
1353-8020
DOI
10.1016/j.parkreldis.2016.06.002
language
English
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no
id
2c78f731-a12c-4804-a25d-1beb03f8fb30
date added to LUP
2016-11-04 11:50:15
date last changed
2017-10-22 05:21:31
@article{2c78f731-a12c-4804-a25d-1beb03f8fb30,
  abstract     = {<p>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 &lt;2 (N = 22), or ≥2 (N = 18) years. Healthcare costs were collected monthly. PD symptoms and QoL were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39), and EuroQoL 5-Dimension Visual Analog Scale (EQ-5D VAS); LCIG dose, safety, and tolerability were monitored. Results Mean monthly costs per patient (€8226 ± 5952) were similar across cohorts, remained steady during 3-year follow-up, and increased with PD severity and QoL impairment. In LCIG-naïve patients, significant improvements compared to baseline were observed on the UPDRS total score and PDQ-39 summary index score through 18 months (n = 24; UPDRS, p = 0.033; PDQ-39, p = 0.049). Symptom control was maintained during 3-year follow-up in LCIG-experienced cohorts. Small changes in mean daily LCIG dose were observed. Adverse events were common and generally related to the device, procedure, levodopa, or laboratory evaluations. Conclusions Costs in LCIG-treated patients were stable over 3 years. LCIG treatment led to significant improvements in motor function and QoL over 18 months in LCIG-naïve patients and no worsening was observed in LCIG-experienced patients over 3 years despite natural PD progression over time. The long-term safety was consistent with the established LCIG profile.</p>},
  author       = {Pålhagen, Sven E. and Sydow, Olof and Johansson, Anders and Nyholm, Dag and Holmberg, Bjorn and Widner, Håkan and Dizdar, Nil and Linder, Jan and Hauge, Tove and Jansson, Rasmus and Bergmann, Lars and Kjellander, Susanna and Marshall, Thomas S.},
  issn         = {1353-8020},
  keyword      = {Cost,Infusion,LCIG,Levodopa,Parkinson's disease},
  language     = {eng},
  month        = {08},
  pages        = {17--23},
  publisher    = {Elsevier},
  series       = {Parkinsonism and Related Disorders},
  title        = {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},
  url          = {http://dx.doi.org/10.1016/j.parkreldis.2016.06.002},
  volume       = {29},
  year         = {2016},
}