title: Clinical management of patients with advanced Parkinson's disease treated with continuous intestinal infusion of levodopa/carbidopa.
abstract: Patients with Parkinson's disease often have a good initial response to dopaminergic therapy but later usually develop motor fluctuations and dyskinesia. In these patients, continuous infusion of levodopa-carbidopa intestinal gel (LCIG) allows for maintaining adequate dopamine levels and for improving motor and nonmotor symptoms, as well as quality of life and autonomy. Adequate candidate selection and follow-up are crucial for treatment success. Management should be multidisciplinary, and patient and caregiver education is a priority. This expert consensus document has been developed by a team of neurologists, gastroenterologists and nurses who have a vast experience in LCIG therapy, with an intention to provide knowledge and tools to facilitate patient management throughout all phases of LCIG treatment process.
authors.affiliation: Section of Neurology, Hospital Arquitecto Marcide, Ferrol University Hospital Complex (CHUF), Ferrol, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Santos García
authors.affiliation: Department of Neurology, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martínez Castrillo
authors.affiliation: Department of Neurology, Hospital del Mar, Barcelona, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Puente Périz
authors.affiliation: Section of Gastrointestinal Endoscopy, Department of Gastroenterology, Hospital del Mar, Barcelona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Seoane Urgorri
authors.affiliation: Department of Gastroenterology, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Servando
authors.initials: S
authors.lastname: Fernández Díez
authors.affiliation: Department of Gastroenterology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Benita León
authors.affiliation: Unit of Movement Disorders & Parkinson's Disease, Gran Canaria University Hospital, Las Palmas de Gran Canaria, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Udaeta Baldivieso
authors.affiliation: Department of Neurology, Movement Disorders Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.|Department of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Campolongo Perillo
authors.affiliation: Nursing Clinic, Department of Neurology, Burgos University Hospital, Burgos, Spain.
authors.forename: Natividad
authors.initials: N
authors.lastname: Mariscal Pérez
mesh_terms: D000978:Antiparkinson Agents / Q000008:administration & dosage*; D002230:Carbidopa / Q000008:administration & dosage* / Q000592:standards; D017028:Caregivers / Q000523:psychology; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005782:Gels / Q000008:administration & dosage / Q000592:standards; D006801:Humans; D007422:Intestines / Q000187:drug effects* / Q000502:physiology; D007980:Levodopa / Q000008:administration & dosage* / Q000592:standards; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D004338:Drug Combinations; D005782:Gels; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa
keywords: advanced Parkinson’s disease; clinical guidelines; dyskinesia; levodopa-carbidopa intestinal gel; motor fluctuations; percutaneous endoscopic gastrostomy