Objective: To describe the clinical outcomes of two patients with GBA Parkinson’s disease (GBA-PD) and severe motor fluctuations treated with subcutaneous foslevodopa/foscarbidopa (fld/fcd) infusion.
Background: Mutations in the glucocerebrosidase gene(GBA) represent a genetic risk factor for Parkinson’s disease (PD). The GBA-PD phenotype is characterized by an earlier age of onset and earlier and more frequent motor fluctuations. However, their treatment with deep brain stimulation (DBS) has been debated due to potential cognitive worsening. There are few data with other device assisted therapies.
Method: We conducted an observational descriptive study of GBA-PD patients managed at a specialized Movement Disorder Unit (MDU) in a tertiary care hospital in Spain. Clinical variables were described.
Results: Out of 36 GBA-PD patients followed at our unit, 2 (5.55%) were treated with fld/fcd. Both patients treated were females (aged 63 and 60) with long-standing PD (9 and 7 years) and the c.896T>Cp.(Ile299Thr) and c.1448T>C (p.L483P) mutations, considered likely pathogenic and severe mutations, respectively. Both were ineligible for DBS due to cognitive impairment.
After 13 and15 months respectively of 24-hour continuous infusion, both patients showed clinical improvement:
Patient 1: Achieved complete resolution of daily “OFF” hours (from 4 to 0) and troublesome biphasic and peak-dose dyskinesia hours (from 7 to 0). Adverse events were limited to mild subcutaneous nodules. Dosage of fld/fcd: basal rate (BR) 0.20, high rate (HR) 0.21mL/h, nocturnal rate (NR) 0.15mL/h, extra dose (ED) 0,25mL.
Patient 2: Demonstrated a reduction in “OFF” time (from 4 to 1 hour), alongside stabilization of cognitive function and improved sleep quality, despite a history of previous hallucinations. No adverse events were reported. Dosage of fld/fcd: BR 0.25, HR 0.27mL/h, NR 0.17mL/h, ED 0,15mL.
Conclusion: Fld/fcd infusion appears to be an effective and safe alternative for managing motor complications in GBA-PD. This therapy allows for stable, continuous dopaminergic stimulation in a population at high risk for fluctuations, cognitive decline, and neuropsychiatric symptoms.
To cite this abstract in AMA style:
I. Muro, E. Casas, P. Lorenzo-Barreto, B. González, L. López-Manzanares. Single centre experience with subcutaneous foslevodopa/foscarbidopa for GBA Parkinson’s disease [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/single-centre-experience-with-subcutaneous-foslevodopa-foscarbidopa-for-gba-parkinsons-disease/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/single-centre-experience-with-subcutaneous-foslevodopa-foscarbidopa-for-gba-parkinsons-disease/