Objective: To evaluate the effect of long-term treatment with levodopa–entacapone–carbidopa intestinal gel (LECIG) infusion on daily time with dyskinesia in people with advanced Parkinson’s disease (PD) by analysis of interim data from the ELEGANCE study (NCT05043103).

Background: Levodopa–entacapone–carbidopa (LECIG) is a device-aided intrajejunal treatment option for patients with advanced PD that is now approved in multiple European countries. ELEGANCE is an ongoing non-interventional study (NCT05043103) being undertaken across 13 European countries that aims to collect data on the safety, efficacy and patient-reported outcomes from LECIG-treated patients in routine clinical practice.

Method: Subjects eligible for participation in ELEGANCE are advanced PD patients with severe motor fluctuations and hyperkinesia or dyskinesia despite optimised PD therapy who have been prescribed LECIG as part of standard clinical care. For this analysis, daily hours spent with dyskinesias were recorded using Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part IV scores for question 4.1.

Results: The planned interim analysis evaluated data for 167 patients from 37 centres. At baseline (V1; initial assessment visit prior to LECIG treatment), patients had a mean (±SD) of 3.64 (±3.30; n=122) daily hours of dyskinesia. Total daily hours with dyskinesia were significantly reduced at V2 (3–6 months of treatment; 2.12±2.87; n=130) and V3 (6–12 months of treatment; 2.23±3.32; n=69); although the reduction was sustained, it did not reach statistical significance at V4 (12–18 months of treatment) (Figure 1). Among the 14/167 patients who had switched from levodopa–carbidopa intestinal gel (LCIG) infusion there was a slight reduction from baseline in dyskinesia at each timepoint, but numbers are too small to draw firm conclusions (Figure 2).

Conclusion: Data from ELEGANCE suggest that long-term treatment with LECIG can improve the daily duration of dyskinesia. In the small number of patients who switched from LCIG to LECIG, there was a trend for a slight reduction in daily hours of dyskinesia.

Figure 1

Figure 2

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MDS Abstracts - https://www.mdsabstracts.org/abstract/treatment-of-advanced-parkinsons-with-levodopa-entacapone-carbidopa-intestinal-gel-impact-on-dyskinesia/