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Intrajejunal levodopa infusion in advanced Parkinson's disease: long-term effects on motor and non-motor symptoms and impact on patient's and caregiver's quality of life.
Eur Rev Med Pharmacol Sci. 2012 Jan; 16(1):79-89.ER

Abstract

BACKGROUND

Continuous infusion of intrajejunal levodopa/carbidopa gel (CIILG) for advanced Parkinson's disease (PD) has been proved to be beneficial on motor complications, non-motor symptoms and quality of life in the short-term follow-up. Aim of this two-center, retrospective, open-label study was to evaluate the long-term effect of CIILG on patients' condition and caregivers' quality of life.

MATERIALS AND METHODS

The assessments (performed at baseline and at latest follow-up available after CIILG) included: the unified PD rating scale (UPDRS I-IV), the non-motor symptoms scale (NMSS), the PD questionnaire (PDQ-8), the PD sleep scale (PDSS), and a battery assessing the cognitive and psychiatric status as well as caregiver's quality of life. Medications were expressed as levodopa equivalent daily dose (LEDD).

RESULTS

14 advanced PD patients (age: 67.0 +/- 11.5 years, disease duration: 12.9 +/- 4.8 years) were followed for 24.9 +/- 14.4 months after CIILG. Total LEDD was unchanged at follow-up, however therapy was globally simplified by reducing dopamine agonists (DAs). A statistically significant beneficial effect was shown on motor complications while the severity of motor symptoms did not change over time. A significant improvement of depressive symptoms and psychiatric side effects caused by DAs was detected. Sleep quality and diurnal somnolence ameliorated as revealed by the significant reduction of PDDS. Caregivers' stress and patients' quality of life were not significantly improved. However, when categorized according to their outcome, patients with improvement of motor condition and functionality gained an improvement of quality of life. Apart from the severity of motor impairment at baseline, no other predicting factors were detected.

CONCLUSIONS

CIILG is an effective treatment option for patients with advanced PD over the long-term period as it may improve both the motor complications and the psychiatric side effects caused by other dopaminergic therapies.

Authors+Show Affiliations

Department of Neurology, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. alfonso.fasano@rm.unicatt.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22338551

Citation

Fasano, A, et al. "Intrajejunal Levodopa Infusion in Advanced Parkinson's Disease: Long-term Effects On Motor and Non-motor Symptoms and Impact On Patient's and Caregiver's Quality of Life." European Review for Medical and Pharmacological Sciences, vol. 16, no. 1, 2012, pp. 79-89.
Fasano A, Ricciardi L, Lena F, et al. Intrajejunal levodopa infusion in advanced Parkinson's disease: long-term effects on motor and non-motor symptoms and impact on patient's and caregiver's quality of life. Eur Rev Med Pharmacol Sci. 2012;16(1):79-89.
Fasano, A., Ricciardi, L., Lena, F., Bentivoglio, A. R., & Modugno, N. (2012). Intrajejunal levodopa infusion in advanced Parkinson's disease: long-term effects on motor and non-motor symptoms and impact on patient's and caregiver's quality of life. European Review for Medical and Pharmacological Sciences, 16(1), 79-89.
Fasano A, et al. Intrajejunal Levodopa Infusion in Advanced Parkinson's Disease: Long-term Effects On Motor and Non-motor Symptoms and Impact On Patient's and Caregiver's Quality of Life. Eur Rev Med Pharmacol Sci. 2012;16(1):79-89. PubMed PMID: 22338551.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrajejunal levodopa infusion in advanced Parkinson's disease: long-term effects on motor and non-motor symptoms and impact on patient's and caregiver's quality of life. AU - Fasano,A, AU - Ricciardi,L, AU - Lena,F, AU - Bentivoglio,A R, AU - Modugno,N, PY - 2012/2/18/entrez PY - 2012/2/18/pubmed PY - 2012/3/13/medline SP - 79 EP - 89 JF - European review for medical and pharmacological sciences JO - Eur Rev Med Pharmacol Sci VL - 16 IS - 1 N2 - BACKGROUND: Continuous infusion of intrajejunal levodopa/carbidopa gel (CIILG) for advanced Parkinson's disease (PD) has been proved to be beneficial on motor complications, non-motor symptoms and quality of life in the short-term follow-up. Aim of this two-center, retrospective, open-label study was to evaluate the long-term effect of CIILG on patients' condition and caregivers' quality of life. MATERIALS AND METHODS: The assessments (performed at baseline and at latest follow-up available after CIILG) included: the unified PD rating scale (UPDRS I-IV), the non-motor symptoms scale (NMSS), the PD questionnaire (PDQ-8), the PD sleep scale (PDSS), and a battery assessing the cognitive and psychiatric status as well as caregiver's quality of life. Medications were expressed as levodopa equivalent daily dose (LEDD). RESULTS: 14 advanced PD patients (age: 67.0 +/- 11.5 years, disease duration: 12.9 +/- 4.8 years) were followed for 24.9 +/- 14.4 months after CIILG. Total LEDD was unchanged at follow-up, however therapy was globally simplified by reducing dopamine agonists (DAs). A statistically significant beneficial effect was shown on motor complications while the severity of motor symptoms did not change over time. A significant improvement of depressive symptoms and psychiatric side effects caused by DAs was detected. Sleep quality and diurnal somnolence ameliorated as revealed by the significant reduction of PDDS. Caregivers' stress and patients' quality of life were not significantly improved. However, when categorized according to their outcome, patients with improvement of motor condition and functionality gained an improvement of quality of life. Apart from the severity of motor impairment at baseline, no other predicting factors were detected. CONCLUSIONS: CIILG is an effective treatment option for patients with advanced PD over the long-term period as it may improve both the motor complications and the psychiatric side effects caused by other dopaminergic therapies. SN - 1128-3602 UR - https://www.unboundmedicine.com/medline/citation/22338551/Intrajejunal_levodopa_infusion_in_advanced_Parkinson's_disease:_long_term_effects_on_motor_and_non_motor_symptoms_and_impact_on_patient's_and_caregiver's_quality_of_life_ L2 - https://ClinicalTrials.gov/search/term=22338551 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -