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Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?

Catalán, Maria José; Antonini, Angelo; Calopa, Matilde; Băjenaru, Ovidiu; de Fábregues, Oriol; Mínguez-Castellanos, Adolfo; Odin, Per LU ; García-Moreno, José Manuel; Pedersen, Stephen W. and Pirtošek, Zvezdan, et al. (2017) In eNeurologicalSci 8. p.44-53
Abstract

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. This article provides an overview of the published... (More)

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. This article provides an overview of the published literature on the benefits, limitations, and drawbacks of LCIG in relation to PD symptoms, the psychosocial impact of the disease, and the quality of life of patients, with the aim of determining candidates for whom treatment with LCIG would be beneficial. According to current evidence, patients with APD (defined as inability to achieve optimal control of the disease with conventional oral treatment), a relatively well-preserved cognitive-behavioral status, and good family/caregiver would count as suitable candidates for LCIG treatment. Contraindications in the opinion of the authors are severe dementia and active psychosis.

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published
subject
keywords
Duodopa, Intrajejunal infusion of levodopa/carbidopa intestinal gel, Motor symptoms, Non-motor symptoms, Parkinson's disease, Quality of life
in
eNeurologicalSci
volume
8
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:85029529253
DOI
10.1016/j.ensci.2017.06.004
language
English
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yes
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f1b7b6f6-dedc-4a69-b132-0a2e8c94253c
date added to LUP
2017-10-02 13:59:46
date last changed
2018-01-07 12:20:14
@article{f1b7b6f6-dedc-4a69-b132-0a2e8c94253c,
  abstract     = {<p>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. This article provides an overview of the published literature on the benefits, limitations, and drawbacks of LCIG in relation to PD symptoms, the psychosocial impact of the disease, and the quality of life of patients, with the aim of determining candidates for whom treatment with LCIG would be beneficial. According to current evidence, patients with APD (defined as inability to achieve optimal control of the disease with conventional oral treatment), a relatively well-preserved cognitive-behavioral status, and good family/caregiver would count as suitable candidates for LCIG treatment. Contraindications in the opinion of the authors are severe dementia and active psychosis.</p>},
  author       = {Catalán, Maria José and Antonini, Angelo and Calopa, Matilde and Băjenaru, Ovidiu and de Fábregues, Oriol and Mínguez-Castellanos, Adolfo and Odin, Per and García-Moreno, José Manuel and Pedersen, Stephen W. and Pirtošek, Zvezdan and Kulisevsky, Jaime},
  keyword      = {Duodopa,Intrajejunal infusion of levodopa/carbidopa intestinal gel,Motor symptoms,Non-motor symptoms,Parkinson's disease,Quality of life},
  language     = {eng},
  month        = {09},
  pages        = {44--53},
  publisher    = {Elsevier},
  series       = {eNeurologicalSci},
  title        = {Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?},
  url          = {http://dx.doi.org/10.1016/j.ensci.2017.06.004},
  volume       = {8},
  year         = {2017},
}