title: Levodopa-entacapone-carbidopa intestinal gel in Parkinson's disease: A randomized crossover study.
abstract: The addition of oral entacapone to levodopa-carbidopa intestinal gel treatment leads to less conversion of levodopa to 3-O-methyldopa, thereby increasing levodopa plasma concentration. The objective of this study was to compare systemic levodopa exposure of the newly developed levodopa-entacapone-carbidopa intestinal gel after a 20% dose reduction with levodopa exposure after the usual levodopa-carbidopa intestinal gel dose in a randomized crossover trial in advanced Parkinson's disease patients.
  
  
  
  In this 48-hour study, 11 patients treated with levodopa-carbidopa intestinal gel were randomized to a treatment sequence. Blood samples were drawn at prespecified times, and patient motor function was assessed according to the treatment response scale.
  
  
  
  Systemic exposure of levodopa did not differ significantly between treatments (ratio, 1.10 [95% confidence interval, 0.951-1.17]). Treatment response scale scores did not significantly differ between treatments (P = 0.84).
  
  
  
  Levodopa-entacapone-carbidopa intestinal gel allowed a lower amount of levodopa administration and was well tolerated. Long-term studies are needed to confirm the results. © 2016 International Parkinson and Movement Disorder Society.
authors.affiliation: Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
authors.forename: Marina
authors.initials: M
authors.lastname: Senek
authors.affiliation: Department of Pharmaceutical Biosciences, Pharmacometrics, Uppsala University, Uppsala, Sweden.
authors.forename: Elisabet I
authors.initials: EI
authors.lastname: Nielsen
authors.affiliation: Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
authors.forename: Dag
authors.initials: D
authors.lastname: Nyholm
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D002230:Carbidopa / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D002396:Catechols / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D018592:Cross-Over Studies; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007980:Levodopa / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D008297:Male; D009570:Nitriles / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D010300:Parkinson Disease / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D002396:Catechols; D004338:Drug Combinations; D009570:Nitriles; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; C071192:entacapone; D002230:Carbidopa
keywords: Parkinson's disease; clinical trials; levodopa infusion; pharmacotherapy; randomized