title: The effect of levodopa-carbidopa intestinal gel infusion long-term therapy on motor complications in advanced Parkinson's disease: a multicenter Romanian experience.
abstract: Chronic treatment with oral levodopa is associated with an increased frequency of motor complications in the late stages of Parkinson's disease (PD). Continuous administration of levodopa-carbidopa intestinal gel (LCIG-Duodopa(®), Abbott Laboratories), which has been available in Romania since 2009, represents an option for treating patients with advanced PD. Our primary objective was to report changes in motor complications after initiation of LCIG therapy. The secondary objectives were as follows: to determine the impact of LCIG therapy on the daily levodopa dose variation before/and after LCIG, to collect patient self-assessments of quality of life (QoL), and to study the overall tolerability and safety of LCIG administration. A retrospective analysis (2009-2013) of LCIG therapy and the experience in nine neurology centers in Romania was performed. The impact of LCIG therapy was evaluated by analyzing changes in motor fluctuations, dyskinesia and the patients' QoL after initiating therapy. The safety of LCIG therapy was estimated by noting agent-related adverse events (AEs) and medical device-related AEs. In the 113 patients included, we observed a significant improvement in PD symptoms after initiation of LCIG therapy. The "on" period increased, with a mean value of 6.14 h, and the dyskinesia period was reduced, with a mean value of 29.4 %. The quantified non-motor symptoms subsided. The patients exhibited significant improvements in QoL scores. There were few AEs and few cases of LCIG therapy discontinuation. LCIG is an important and available therapeutic option for managing patients with advanced PD.
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Carol Davila" Bucharest, University Emergency Hospital Bucharest, 169 Splaiul Independentei, Sector 5, Bucharest, Romania.
authors.forename: O
authors.initials: O
authors.lastname: Băjenaru
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Carol Davila" Bucharest, University Emergency Hospital Bucharest, 169 Splaiul Independentei, Sector 5, Bucharest, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Ene
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Carol Davila" Bucharest, Colentina Hospital, 19-21 Stefan cel Mare Street, Sector 2, 020125, Bucharest, Romania.
authors.forename: B O
authors.initials: BO
authors.lastname: Popescu
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy Targu Mures, 38 Gh Marinescu Street, 540139, Targu Mures, Mures, Romania.
authors.forename: J A
authors.initials: JA
authors.lastname: Szász
authors.affiliation: Department of Neurology, Emergency Clinical Hospital Oradea, 65 Gh Doja Street, 410169, Oradea, Bihor, Romania.
authors.forename: M
authors.initials: M
authors.lastname: Sabău
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, Cluj County Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: D F
authors.initials: DF
authors.lastname: Mureşan
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, Cluj County Hospital, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania.
authors.forename: L
authors.initials: L
authors.lastname: Perju-Dumbrava
authors.affiliation: Neurology Rehabilitation Department, University of Medicine and Pharmacy "Gr. T. Popa" Iasi, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661, Iasi, Romania.
authors.forename: C D
authors.initials: CD
authors.lastname: Popescu
authors.affiliation: Neurology Rehabilitation Department, University of Medicine and Pharmacy "Gr. T. Popa" Iasi, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661, Iasi, Romania.
authors.forename: A
authors.initials: A
authors.lastname: Constantinescu
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Carol Davila" Bucharest, Colentina Hospital, 19-21 Stefan cel Mare Street, Sector 2, 020125, Bucharest, Romania.
authors.forename: I
authors.initials: I
authors.lastname: Buraga
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy "Victor Babes," Timisoara County Hospital, 10 Iosif Bulbuca Street, 300736, Timisoara, Timis, Romania. mihaelasimu6713@gmail.com.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-9676-1282
authors.initials: M
authors.lastname: Simu
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D002230:Carbidopa / Q000008:administration & dosage*; D004338:Drug Combinations; D005260:Female; D015390:Gastric Bypass; D005782:Gels; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000188:drug therapy / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D012189:Retrospective Studies; D012383:Romania
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; D005782:Gels; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa
keywords: Levodopa–carbidopa intestinal gel (LCIG); Motor complications; Parkinson’s disease; Quality of life