Objective: To evaluate motor and non-motor outcomes, including sleep disturbances, of continuous subcutaneous foslevodopa/foscarbidopa infusion in a heterogeneous real-world cohort of patients with advanced Parkinson’s disease (aPD)

Background: Continuous subcutaneous foslevodopa/foscarbidopa infusion (LDp/CDp) has demonstrated efficacy in reducing motor fluctuations in clinical trials. However, real-world evidence remains scarce, particularly regarding non-motor symptoms, sleep disturbances and quality of life.

Method: Observational real-world study including patients with aPD who initiated LDp/CDp between May 2024 and February 2026. Outcomes included OFF time, motor function (MDS-UPDRS), troublesome dyskinesia, non-motor symptoms (NMS-Quest), sleep symptoms and quality of life (EQ-VAS).

Results: Twenty-one patients (11 men), aged 29–81 years, with disease duration of 3–49 years and motor fluctuations for 1–33 years were included. Patients received daytime-only (8 patients) or 24-hour (13) regimens and treatment optimization required 2–4 visits. Mean OFF time decreased from 5.4 to 1.0 hours (≈81% reduction) and MDS-UPDRS improved from 25.9 to 14.9. Dyskinesias improved in all patients except one, becoming non-troublesome and disappearing in some cases. Quality of life improved significantly (EQ-VAS 52.5 to 71.9; +36.9%). Non-motor symptoms improved, particularly depressive symptoms, anxiety, apathy, cognitive complaints and falls. Nocturnal symptoms improved in 76% of patients, mainly insomnia and RBD, including individuals treated with daytime-only infusion. Concomitant antiparkinsonian medication was reduced in 81% of patients and 14% remained on LDp/CDp monotherapy. Cutaneous reactions occurred in 43%, mostly mild. Neuropsychiatric adverse events occurred in 14% and resolved after adjustment of oral medication. Five patients discontinued treatment (24%), none due to inefficacy or serious adverse events.

Conclusion: In real-world clinical practice, the beneficial effects of LDp/CDp on motor fluctuations are confirmed. Notably, our findings highlight clinically meaningful benefits in non-motor symptoms and quality of life in a heterogeneous population including patients often underrepresented in clinical trials.

References: • Soileau MJ, Aldred J, Budur K, et al. Safety and efficacy of continuous subcutaneous foslevodopa-foscarbidopa in patients with advanced Parkinson’s disease: a randomised, double-blind, active-controlled, phase 3 trial. Lancet Neurol. 2022;21(12):1099-1109.
• Aldred J, Freire-Alvarez E, Amelin AV, et al. Continuous subcutaneous foslevodopa/foscarbidopa in Parkinson’s disease: safety and efficacy results from a 12-month, single-arm, open-label, phase 3 study. Neurol Ther. 2023;12:1937-1958.
• Bradley M, Coran M, Donlon E, et al. Foslevodopa/foscarbidopa continuous subcutaneous infusion in Parkinson’s disease: extended real-world data with outpatient dose titration. Mov Disord Clin Pract. 2025. doi:10.1002/mdc3.70397.
• Rukavina K, Ebersbach G, Gruber D. Foslevodopa/foscarbidopa continuous subcutaneous infusion in Parkinson’s disease: real-world short-term data on tolerability and medication adjustments. Mov Disord Clin Pract. 2025.
• Aubignat M, Tir M. Continuous subcutaneous foslevodopa-foscarbidopa in Parkinson’s disease: a mini-review of current scope and future outlook. Mov Disord Clin Pract. 2024;11(10):1188-1194.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/beyond-motor-fluctuations-non-motor-and-quality-of-life-outcomes-with-subcutaneous-foslevodopa-foscarbidopa-infusion-in-real-world-practice/