Objective: To report the experience with levodopa–entacapone–carbidopa intestinal gel infusion (LECIG) for the management of advanced Parkinson’s disease (PD) from a Romanian center.

Background: LECIG is a device-aided PD therapy approved in Romania in 2022 for the management of patients with advanced disease. The presence of entacapone in LECIG increases the bioavailability of levodopa compared with standard levodopa–carbidopa intestinal gel infusion (LCIG), allowing a reduced levodopa dose (by 20–35%) to be given to achieve the same effective plasma levodopa levels. The Crono LECIG pump is also smaller and lighter than standard LCIG pump.

Method: We undertook a retrospective, observational analysis of advanced PD patients initiated on treatment with LECIG at our center in order to assess efficacy, adverse events and the perception of patients and caregivers of the treatment, including the Crono LECIG pump device.

Results: Five patients were included in the analysis: three patients were initiated de novo onto LECIG and two patients switched from LCIG to LECIG. Patient characteristics were: median age 67 years, mean disease duration 11.3 years, median treatment duration 10 years. The two patients who switched from LCIG had been on this treatment for 8 years and 5 years, respectively. Median MDS–UPDRS scores for all patients was 71 prior to starting LECIG. The median optimized morning dose of LECIG was 8.8 ml and the median optimized continuous infusion dose was 2.9 ml/hour (one patient needed two different continuous doses during the day). Median MDS–UPDRS scores after initiation onto LECIG were 44, with improvements in scores for motor symptoms, activities of daily living and duration and intensity of troublesome dyskinesia. Adverse events reported were pain and discomfort related to PEG-J insertion for up to two weeks after the procedure. No patients discontinued LECIG treatment. Caregivers and patients reported that the pump was relatively light, easy to use and allowed the setting of multiple continuous doses.

Conclusion: Our data showed that LECIG was well tolerated by patients and improved motor symptoms, including duration of ‘OFF’ periods, and reduced painful dyskinesias. The device was well accepted by patients and their caregivers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/levodopa-entacapone-carbidopa-intestinal-gel-infusion-for-advanced-parkinsons-disease-patients-data-from-a-romanian-center/