BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) effectively reduces off time and dyskinesia and increases on time in advanced Parkinson's disease (PD). However, patients with LCIG-infusion experience frequent complications and some discontinue treatment early on. OBJECTIVES: The objectives of this study were to find predictive factors for early dropout from the LCIG infusion, analyze the treatment burden on the tertiary health care system, and explore changes in medication during the LCIG treatment. METHODS: LCIG-infusion was administrated to 103 patients between July 2006 and May 2020 at the Helsinki University Hospital, accumulating 350 years of follow-up data. We evaluated, retrospectively, changes in medication during treatment, discontinuation of the infusion, and adverse events from the patient records. RESULTS: Living alone was a predictive factor for early dropout (OR = 3.88; 95% CI = 1.03-14.66; P = 0.045). The treatment burden on the tertiary health care system increased after the initiation of LCIG infusion mostly because of common complications related to the infusion system (median change of in- and out-patient visits +1, P = 0.03). Mean levodopa equivalent daily dose (LEDD) rose from baseline to 6 months (1246.7 vs. 1684.9, P = 0.001) and stabilized thereafter. Patients commonly switched from "polypharmacy" to "LCIG-only" or "LCIG + oral levodopa" medication-groups during long-term treatment. CONCLUSIONS: Recurrent complications related to the infusion system increase the treatment burden on tertiary healthcare system after the initiation of LCIG-infusion. Most patients continue long-term with the infusion. Few patients discontinue infusion during the first year after initiation and living alone appears to be a risk factor for this outcome.
BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) effectively reduces off time and dyskinesia and increases on time in advanced Parkinson's disease (PD). However, patients with LCIG-infusion experience frequent complications and some discontinue treatment early on. OBJECTIVES: The objectives of this study were to find predictive factors for early dropout from the LCIG infusion, analyze the treatment burden on the tertiary health care system, and explore changes in medication during the LCIG treatment. METHODS: LCIG-infusion was administrated to 103 patients between July 2006 and May 2020 at the Helsinki University Hospital, accumulating 350 years of follow-up data. We evaluated, retrospectively, changes in medication during treatment, discontinuation of the infusion, and adverse events from the patient records. RESULTS: Living alone was a predictive factor for early dropout (OR = 3.88; 95% CI = 1.03-14.66; P = 0.045). The treatment burden on the tertiary health care system increased after the initiation of LCIG infusion mostly because of common complications related to the infusion system (median change of in- and out-patient visits +1, P = 0.03). Mean levodopa equivalent daily dose (LEDD) rose from baseline to 6 months (1246.7 vs. 1684.9, P = 0.001) and stabilized thereafter. Patients commonly switched from "polypharmacy" to "LCIG-only" or "LCIG + oral levodopa" medication-groups during long-term treatment. CONCLUSIONS: Recurrent complications related to the infusion system increase the treatment burden on tertiary healthcare system after the initiation of LCIG-infusion. Most patients continue long-term with the infusion. Few patients discontinue infusion during the first year after initiation and living alone appears to be a risk factor for this outcome.
Authors: Mariachiara Sensi; F Preda; L Trevisani; E Contini; D Gragnaniello; J G Capone; E Sette; N Golfre-Andreasi; V Tugnoli; M R Tola; R Quatrale Journal: J Neural Transm (Vienna) Date: 2014-01-08 Impact factor: 3.575
Authors: Haidar S Dafsari; Pablo Martinez-Martin; Alexandra Rizos; Maja Trost; Maria Gabriela Dos Santos Ghilardi; Prashanth Reddy; Anna Sauerbier; Jan Niklas Petry-Schmelzer; Milica Kramberger; Robbert W K Borgemeester; Michael T Barbe; Keyoumars Ashkan; Monty Silverdale; Julian Evans; Per Odin; Erich Talamoni Fonoff; Gereon R Fink; Tove Henriksen; Georg Ebersbach; Zvezdan Pirtošek; Veerle Visser-Vandewalle; Angelo Antonini; Lars Timmermann; K Ray Chaudhuri Journal: Mov Disord Date: 2019-02-04 Impact factor: 10.338
Authors: C Warren Olanow; Karl Kieburtz; Per Odin; Alberto J Espay; David G Standaert; Hubert H Fernandez; Arvydas Vanagunas; Ahmed A Othman; Katherine L Widnell; Weining Z Robieson; Yili Pritchett; Krai Chatamra; Janet Benesh; Robert A Lenz; Angelo Antonini Journal: Lancet Neurol Date: 2013-12-20 Impact factor: 44.182
Authors: Barbara Anne Pickut; Chris van der Linden; Sophie Dethy; Hilde Van De Maele; Diederik Zegers de Beyl Journal: Neurol Sci Date: 2013-12-31 Impact factor: 3.307
Authors: Alberto Romagnolo; Aristide Merola; Carlo Alberto Artusi; Mario Giorgio Rizzone; Maurizio Zibetti; Leonardo Lopiano Journal: Mov Disord Clin Pract Date: 2018-11-08
Authors: Eric Freire-Alvarez; Egon Kurča; Lydia Lopez Manzanares; Eero Pekkonen; Cleanthe Spanaki; Paola Vanni; Yang Liu; Olga Sánchez-Soliño; Luigi M Barbato Journal: Mov Disord Date: 2021-07-08 Impact factor: 9.698
Authors: David G Standaert; Ramon L Rodriguez; John T Slevin; Michael Lobatz; Susan Eaton; Krai Chatamra; Maurizio F Facheris; Coleen Hall; Kavita Sail; Yash J Jalundhwala; Janet Benesh Journal: Mov Disord Clin Pract Date: 2017-09-20
Authors: Filip Bergquist; Mats Ehrnebo; Dag Nyholm; Anders Johansson; Fredrik Lundin; Per Odin; Per Svenningsson; Fredrik Hansson; Leif Bring; Elias Eriksson; Nil Dizdar Journal: Neurology Date: 2022-06-15 Impact factor: 11.800