Objective: To clarify the actual status of CSCI therapy, cases in which CSCI therapy was started at our hospital were investigated.

Background: Continuous subcutaneous infusion (CSCI) of foslevodopa/foscarbidopa has recently been added to device aided therapy for advanced Parkinson’s disease (PD). This pump was released on the market in Japan in July 2023. However, discontinuations due to an inadequate effect, hallucinations, and skin disorders have been reported.

Method: Patients with advanced PD who received CSCI therapy at our hospital between October 2023 and January 2025 were investigated. Diagnoses were made based on international diagnostic criteria for PD. The patients’ background and clinical characteristics (Hoehn and Yahr stage, medication status, CSCI volume, side effects, etc.) were retrospectively collected from electronic medical records and analyzed using descriptive statistics to clarify the patients’ characteristics.

Results: Sixteen patients (11 men, 5 women) with PD received CSCI therapy at our hospital. The mean age at the time of therapy initiation was 69.1 (53–86) years. The mean HY stage was 3.4 (2–5), and the mean duration of illness was 13.4 (4–35) years. The mean Unified Parkinson’s Disease Rating Scale Part III score prior to therapy was 19.5 (± 15.8), and the levodopa equivalent was 1,066.4 (± 448.2) mg/day, of which levodopa-containing preparations accounted for 651.5 (± 270.6) mg/day. Anti-PD drugs were used in combination with CSCI therapy in 15 patients, of whom 10 received oral medication, and 13 received patches. Five patients dropped out of the study, and two of these patients resumed the study. The reasons for discontinuation were psychiatric symptoms such as hallucinations in three patients, an inadequate effect in one patient, and self-discontinuation in one patient. Skin disorders occurred in three patients who did not discontinue the therapy. Improvements were seen in wearing off and dyskinesia, and, with the exception of one patient, no anti-PD drugs were discontinued.

Conclusion: CSCI therapy is the third wearable therapy that promises to improve wearing off and dyskinesia without surgical intervention. CSCI therapy is expected to improve patients’ quality of life, with the option of dose reduction or discontinuation of anti-PD drugs, as well as the option to resume therapy if patients discontinue due to psychiatric or skin symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-efficacy-and-safety-of-continuous-subcutaneous-infusion-therapy-with-foslevodopa-foscarbidopa/