Objective: To determine the number of patients that maintain infusion therapies (continuous subcutaneous apomorphine infusion (CSAI) and levodopa-carbidopa intestinal gel (LCIG)) as treatment for advanced Parkinson’s disease (APD) in a movement disorder unit in Spain. To describe the reasons for withdrawal and to study the presence of side effects.
Background: Different studies have shown the efficacy of these therapies to treat motor fluctuations. However, clinical practice review could give more information regarding maintenance and emergence and temporality of side effects.
Method: Observational retrospective study amongst a sample of patients treated with infusion therapies for APD. Data were collected retrospectively from the therapies started between Jan 2010- Jan 2023. Descriptive statistical analyses were performed in CSAI and LCIG groups; some patients were enrolled in both groups.
Results: N=80. 47 LCIG group and 46 CSAI group.
The mean age in LCIG group was 70 [44-85], in CSAI group was 65 [50-81]. The mean number of years since PD diagnosis until the initiation of LCIG was 15 [3-38] and of CSAI was 13.5 [1-44].
The mean number of years that patients maintained LCIG was 3.3, for CSAI was 1.8. 27 patients maintained LCIG ≥2 years (57.5%), 12 kept CSAI (26.7%).
13 patients (27.7%) discontinued LCIG: 4 due to complications of the infusion system, 4 due to drug side effects, 4 due to motor and 1 due to cognitive progression.
Regarding CSAI, 31 patients (67.4%) discontinued therapy: 13 due to drug side effects, 7 used it as a bridge to DBS, 5 due to cognitive worsening, 4 due to system malfunction and 2 due to absence of motor improvement.
The most frequent side effects with LCIG were granuloma (23.4%) and stoma dermatitis (21.28%). The most frequent side effects with CSAI were nodules (56.5%) and somnolence (21.7%).
All side effects were more frequent during the first two years (granuloma 72.7 vs 27.3%, stoma dermatitis 70 vs 30%, nodules 92.3 vs 7.7%, somnolence 100 vs 0%).
Conclusion: LCIG was maintained longer than CSAI in our cohort of patients. CSAI patients reported more side effects and in both therapies they were more frequent during the first two years. They were considered of mild intensity. These findings line up with previous descriptions in literature.
To cite this abstract in AMA style:
I. Muro Garcia, J. Alonso Maroto, B. Gonzalez Garcia, E. Carabajal Pendon, E. Casas, L. Lopez Manzanares. Continuity and presence of side effects of continuous subcutaneous apomorphine infusion and levodopa-carbidopa intestinal gel infusion in advanced Parkinson’s disease, in a movement disorder unit in Spain [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/continuity-and-presence-of-side-effects-of-continuous-subcutaneous-apomorphine-infusion-and-levodopa-carbidopa-intestinal-gel-infusion-in-advanced-parkinsons-disease-in-a-movement-disorder-u/. Accessed June 15, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/continuity-and-presence-of-side-effects-of-continuous-subcutaneous-apomorphine-infusion-and-levodopa-carbidopa-intestinal-gel-infusion-in-advanced-parkinsons-disease-in-a-movement-disorder-u/