Objective: To evaluate the efficacy of Levodopa-Entacapone-Carbidopa Intestinal Gel (LECIG) in advanced Parkinson’s Disease (APD).

Background: LECIG infusion has been available in Romania since 2021. This study aims to evaluate the clinical parameters of patients diagnosed with APD who were initiated on LECIG therapy, assessing their status both before treatment initiation and at hospital discharge.

Method: A cohort of APD patients, naïve to enteral levodopa infusion, was prospectively analyzed following LECIG initiation in a university-affiliated tertiary care center. Patients underwent hospitalization for dose titration, therapy initiation, dose optimization, and evaluation of treatment efficacy. Comprehensive demographic and clinical data were collected, including age, sex, disease duration, disease severity, motor complications, and cognitive function. The characterization of motor complications encompassed a detailed assessment of motor fluctuations (OFF period duration, early morning akinesia, delayed ON, no ON, and sudden OFF episodes), dyskinesias (peak-dose, diphasic, and dystonic), and the presence of freezing episodes.

Results: In three years, LECIG treatment was initiated in 41 patients. Disease duration was 10.5±4.2 years and overall age was 65.4±8.3 years (mean ± SD), with a male/female ratio of 1.3. The patients had an off state of 4.7±0.8 hours/day. Twenty-five patients suffered from moderately severe peak-dose dyskinesia (2.8±1.2 hours/day) and 8 patients from severe dyskinesia (2.3±1.0 hours/day). After LECIG initiation, the duration of the off periods decreased significantly (1.7±2.2 hours/day). There was a similar trend for moderate dyskinesias (23 patients, 1.4±0.6 hours/day, 2 patients without dyskinesias), while severe dyskinesias disappeared utterly. The sudden off that occurred in 8 patients, was present in a single patient after the initiation of LECIG.

Conclusion: The therapeutic efficacy of LECIG in mitigating motor complications is comparable to that of levodopa–carbidopa intestinal gel (LCIG), with the added benefits of a reduced daily levodopa requirement and a more compact administration device. However, further longitudinal studies and extended clinical experience are required to determine the relative advantages of these two enteral levodopa formulations within the framework of personalized treatment strategies for advanced Parkinson’s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/three-year-single-center-experience-with-levodopa-entacapone-carbidopa-intestinal-gel-in-advanced-parkinsons-disease/