Objective: To describe the improvement of motor complications in patients with advanced Parkinson’s Disease (APD) treated with Levodopa-Entacapone-Carbidopa Intestinal Gel (LECIG).

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

Method: A cohort of 50 consecutive APD patients, naïve to enteral levodopa infusion, was evaluated following LECIG initiation in a university-affiliated tertiary hospital. Patients underwent continuous hospitalization for dose titration, therapy initiation, dose optimization, and evaluation of treatment efficacy. Comprehensive demographic and clinical data were collected: age, sex, disease duration and severity, profile of motor complications (OFF periods duration, early morning akinesia, delayed ON, no ON, sudden OFF episodes, peak-dose and/or diphasic dyskinesias, end of dose dystonia, freezing) and cognitive function assessed via the Mini-Mental State Examination.

Results: In four years, LECIG treatment was initiated in 50 patients. Disease duration was 10.0±4.01 years and mean age of 65.2±8.65 years (range: 45-82 years; median: 67 years). The patients had an OFF state of 4.63±0.75 hours/day. Thirty-three patients suffered from moderately severe peak-dose dyskinesia (2.65±1.22 hours/day) and 9 patients from severe dyskinesia (2.78±1.66 hours/day). After LECIG initiation, the duration of the OFF periods decreased significantly (1.62±1.97 hours/day). There was a similar trend for moderate dyskinesias (29 patients, 1.40±0.56 hours/day, 4 patients without dyskinesias), while severe dyskinesias disappeared completely. The sudden OFF that occurred in 9 patients was present only in a single patient at discharge.

Conclusion: The therapeutic benefit of LECIG in mitigating motor complications in APD patients is comparable to that of levodopa-carbidopa intestinal gel, with the advantages of lower total daily doses of levodopa and a more compact administration device. As more clinical experience with this device assisted therapeutical option accumulates, one can assume the profile of the patient who will benefit maximally from these alternatives can be defined more accurately.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/levodopa-entacapone-carbidopa-intestinal-gel-in-advanced-parkinsons-disease-a-four-year-real-life-experience/