Use of levodopa-carbidopa intestinal gel to treat patients with multiple system atrophy. (July 2022)

• Record Type: Journal Article
• Authors: Blaise, A.S.; Cuvelier, E.; Carrière, N.; Devos, D.; Moreau, F.; Defebvre, L.; Mutez, E.
• Is Part Of: Parkinsonism & related disorders. Volume 100(2022)
• Page Start: 41
• Page End: 44
• Publication Date: 2022-07
• Subjects: Multiple system atrophy -- Motor fluctuations -- Continuous dopaminergic stimulation -- Levodopa-carbidopa intestinal gel -- Levodopa-responsiveness; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2022.05.018
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Background: Levodopa-carbidopa intestinal gel (LCIG) is an effective treatment for late-stage Parkinson's disease (PD) but had not been evaluated in levodopa-responsive patients with the parkinsonian variant of multiple system atrophy (MSA-P) and motor fluctuations. We aimed to assess the safety of LCIG in MSA-P patients. Methods: In a retrospective, single-center study, we analyzed clinical and treatment-related data for all patients with MSA-P or PD treated with LCIG between December 2004 and November 2017. Adverse events (AEs) were classified into three classes: AEs related to gastrointestinal effects or to the PEG-J procedure, AEs related to the device, and AEs related to the pharmacological effect of LCIG. Results: 7 MSA-P and 63 PD patients had been treated with LCIG for a median [interquartile range] period of 31 [16;43] and 19 [8;45] months, respectively. There were no significant intergroup differences in safety. Enteral nutrition was introduced at the same time as LCIG treatment in 4 (57%) MSA-P patients. In the MSA-P and PD groups, LCIG was associated with a better Global Clinical Impression score and discontinuation of oral anti-parkinsonian drugs (in 43% and 27% of cases, respectively). Conclusions: LCIG treatment is feasible in MSA-P patients with severe motor complications. The safety profile is similar to that seen in PD. Highlights: One third of MSA-P patients show a levodopa-responsiveness. LCIG may be used in levodopa-responsive patients with MSA-P. The safety profile of LCIG treatment in MSA-P appears to be similar to that in PD.