Category: Parkinson's Disease (Other)
Objective: To characterize discontinuation patterns, reasons, and baseline predictors of therapy cessation in a prospective FLC/FCD cohort.
Background: Real-world discontinuation rates for continuous subcutaneous FLD/FCD vary from 21% to 40% across early-adoption centres. Identifying predictive factors is important for patient selection and counselling.
Method: Twenty-eight patients with advanced Parkinson’s disease initiated on FLC/FCD were retrospectively analyzed. Reasons for discontinuation were documented. Baseline demographic, clinical, dosing, and adverse-event variables were compared between continuers (n=22) and discontinuers (n=6).
Results: Six patients (21.4%) discontinued therapy after a mean of 4.8 ± 3.3 months (range 1–10). Primary reasons were infusion-site adverse events (n=4, 66.7%), lack of therapeutic response (n=1, 16.7%), and logistical/compliance challenges (n=1, 16.7%). Discontinuers showed trends toward higher baseline LEDD (1274 ± 628 vs 948 ± 554 mg/day, p=0.26) and greater baseline non-motor symptom burden (78.3 ± 35.5 vs 57.7 ± 23.5, p=0.24), although differences were not statistically significant. Infusion-site adverse events occurred in 78.6% of patients (22/28) but resulted in discontinuation in only 18.2% (4/22 with events). Mean cannula replacement interval was 1.8 ± 0.5 days. Inpatient titration duration, initial dosing parameters, motor severity, and phenotype distribution were similar between groups.
Conclusion: The discontinuation rate (21.4%) aligns with pivotal trial experience. Infusion-site reactions remain the dominant barrier, though most patients adapt successfully. Higher baseline medication burden and non-motor symptom severity may identify patients at risk for discontinuation, warranting enhanced dermatological support and closer follow-up during the first months of treatment.
To cite this abstract in AMA style:
K. Waqar, M. Thomas, Y. Abdelmajid, E. Freitas, R. Cabrito, RH. Battah, A. Anjum, SH. Mittal. Discontinuation Patterns and Predictive Factors in Continuous Subcutaneous Foslevodopa/Foscarbidopa (FLC/FCD) Therapy: Insights from Early Clinical Experience [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/discontinuation-patterns-and-predictive-factors-in-continuous-subcutaneous-foslevodopa-foscarbidopa-flc-fcd-therapy-insights-from-early-clinical-experience/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/discontinuation-patterns-and-predictive-factors-in-continuous-subcutaneous-foslevodopa-foscarbidopa-flc-fcd-therapy-insights-from-early-clinical-experience/