Session Information
Date: Thursday, June 23, 2016
Session Title: Pharmacology
Session Time: 12:00pm-1:30pm
Objective: To compare the systemic levodopa exposure during administration of levodopa-entacapone-carbidopa (LECIG) intestinal gel with levodopa-carbidopa intestinal gel (LCIG) in advanced Parkinson’s disease (PD) patients.
Background: LCIG is a well-established and effective treatment for patients with advanced PD. Levodopa has two major metabolic pathways, aromatic amino acid decarboxylation (AADC) pathway and the catechol-O-methyl transferase (COMT) pathway. An addition of a COMT-inhibitor may allow a lower dose administration of levodopa.
Methods: This study was a randomized, 1+1 day, cross-over infusion trial. Patients (n=11) were randomized to LCIG-LECIG or LECIG-LCIG. The duration of the continuous infusion, including the morning dose, was 14 h. The LCIG dose was individually optimized before trial initiation. The LECIG morning dose was 80% or 90% of the regular LCIG morning dose infusion duration. The LECIG continuous flow rate was 80 % of the LCIG flow rate. Blood samples were drawn at pre-specified time points and trained study personnel assessed the patients’ motor function according to the treatment response scale (TRS).
Results: AUC0-14 for levodopa (LD) and carbidopa (CD) did not differ significantly between the two treatments. AUC0-14/dose was significantly higher during LECIG compared with LCIG for both LD and CD. Mean 3-OMD levels were declining during LECIG administration. The TRS scores throughout the 14 hours of infusion did not significantly differ between the treatments.
Conclusions: LECIG, containing entacapone, allows a lower amount of LD administration without compromising treatment effect. The treatment was well tolerated at the administered doses. LECIG is administered with a smaller, lighter pump than LCIG and may become a promising new treatment option for patients with advanced Parkinson’s disease.
To cite this abstract in AMA style:
M. Senek, D. Nyholm. Levodopa-entacapone-carbidopa intestinal gel in Parkinson’s disease – A randomized, crossover infusion study [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/levodopa-entacapone-carbidopa-intestinal-gel-in-parkinsons-disease-a-randomized-crossover-infusion-study/. Accessed June 15, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/levodopa-entacapone-carbidopa-intestinal-gel-in-parkinsons-disease-a-randomized-crossover-infusion-study/