Levodopa-carbidopa intestinal gel infusion in Parkinson's disease
Rosqvist, Kristina LU and Odin, Per LU
(2024)
In International Review of Movement Disorders
7.
p.31-48
- Abstract
To effectively treat motor fluctuations and dyskinesia in advanced Parkinson's disease (PD), intestinal levodopa therapy can be carried out by continuous delivery of levodopa-carbidopa intestinal gel (LCIG; Duodopa®). LCIG is delivered with a portable pump system over tubing, entering the stomach through a percutaneous endoscopic gastrojejunostomy (PEG-J) and continuing to the proximal part of the small intestine where the drug is delivered. Unlike peroral therapies, the LCIG system provides constant drug delivery, aiming for continuous dopaminergic stimulation. The most frequent indication for moving from non-invasive to device-aided therapies is insufficient control of motor complications. The effect of LCIG on motor fluctuations and... (More)
To effectively treat motor fluctuations and dyskinesia in advanced Parkinson's disease (PD), intestinal levodopa therapy can be carried out by continuous delivery of levodopa-carbidopa intestinal gel (LCIG; Duodopa®). LCIG is delivered with a portable pump system over tubing, entering the stomach through a percutaneous endoscopic gastrojejunostomy (PEG-J) and continuing to the proximal part of the small intestine where the drug is delivered. Unlike peroral therapies, the LCIG system provides constant drug delivery, aiming for continuous dopaminergic stimulation. The most frequent indication for moving from non-invasive to device-aided therapies is insufficient control of motor complications. The effect of LCIG on motor fluctuations and dyskinesia has a high degree of evidence according to published observations. Controlled studies during the past decade have shown that changing from peroral levodopa to LCIG therapy results in a stabilisation of the clinical status, with a pronounced reduction in time spent in “off” and a pronounced increase in time spent in “on” without troublesome dyskinesia. There is an increasing amount of evidence for its effect also on several non-motor symptoms (NMS) such as sleep and mood disturbances. A number of studies have shown improvement in health-related quality of life (HRQoL) and long-term studies have shown that improvement in HRQoL is stable over a long time with LCIG therapy. The most common problems with LCIG therapy are found on the technical side of the treatment, e.g., with the pump, the tubing and the PEG-J. Otherwise, the side effects are similar to those of peroral levodopa therapy with one exception, which is polyneuropathy, which may develop with long term LCIG infusion. In conclusion, LCIG therapy is very effective on motor symptoms, NMS and usually improves QoL not only for the patients but also for their carers.
(Less)
- author
- Rosqvist, Kristina
LU
and Odin, Per
LU
- organization
- publishing date
- 2024-01-01
- type
- Chapter in Book/Report/Conference proceeding
- publication status
- published
- subject
- keywords
- Advanced Parkinson's disease, Continuous dopaminergic stimulation, Infusion, Levodopa, Pump
- host publication
- International Review of Movement Disorders
- series title
- International Review of Movement Disorders
- volume
- 7
- pages
- 18 pages
- publisher
- Elsevier Science Publishers B.V.
- external identifiers
-
- scopus:105038672920
- ISSN
- 2666-7878
- 2666-7886
- DOI
- 10.1016/bs.irmvd.2024.05.001
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2024 Published by Elsevier Inc.
- id
- f6f79d7f-000b-47ab-b774-fa772e780193
- date added to LUP
- 2026-07-14 14:46:33
- date last changed
- 2026-09-08 19:42:03
@inbook{f6f79d7f-000b-47ab-b774-fa772e780193,
abstract = {{<p>To effectively treat motor fluctuations and dyskinesia in advanced Parkinson's disease (PD), intestinal levodopa therapy can be carried out by continuous delivery of levodopa-carbidopa intestinal gel (LCIG; Duodopa®). LCIG is delivered with a portable pump system over tubing, entering the stomach through a percutaneous endoscopic gastrojejunostomy (PEG-J) and continuing to the proximal part of the small intestine where the drug is delivered. Unlike peroral therapies, the LCIG system provides constant drug delivery, aiming for continuous dopaminergic stimulation. The most frequent indication for moving from non-invasive to device-aided therapies is insufficient control of motor complications. The effect of LCIG on motor fluctuations and dyskinesia has a high degree of evidence according to published observations. Controlled studies during the past decade have shown that changing from peroral levodopa to LCIG therapy results in a stabilisation of the clinical status, with a pronounced reduction in time spent in “off” and a pronounced increase in time spent in “on” without troublesome dyskinesia. There is an increasing amount of evidence for its effect also on several non-motor symptoms (NMS) such as sleep and mood disturbances. A number of studies have shown improvement in health-related quality of life (HRQoL) and long-term studies have shown that improvement in HRQoL is stable over a long time with LCIG therapy. The most common problems with LCIG therapy are found on the technical side of the treatment, e.g., with the pump, the tubing and the PEG-J. Otherwise, the side effects are similar to those of peroral levodopa therapy with one exception, which is polyneuropathy, which may develop with long term LCIG infusion. In conclusion, LCIG therapy is very effective on motor symptoms, NMS and usually improves QoL not only for the patients but also for their carers.</p>}},
author = {{Rosqvist, Kristina and Odin, Per}},
booktitle = {{International Review of Movement Disorders}},
issn = {{2666-7878}},
keywords = {{Advanced Parkinson's disease; Continuous dopaminergic stimulation; Infusion; Levodopa; Pump}},
language = {{eng}},
month = {{01}},
pages = {{31--48}},
publisher = {{Elsevier Science Publishers B.V.}},
series = {{International Review of Movement Disorders}},
title = {{Levodopa-carbidopa intestinal gel infusion in Parkinson's disease}},
url = {{http://dx.doi.org/10.1016/bs.irmvd.2024.05.001}},
doi = {{10.1016/bs.irmvd.2024.05.001}},
volume = {{7}},
year = {{2024}},
}