Objective: To evaluate the efficacy and safety of subcutaneous levodopa/carbidopa or prodrug infusions in reducing OFF-time and improving quality of life in patients with Parkinson’s disease.
Background: Many patients with Parkinson’s disease experience motor fluctuations despite oral levodopa/carbidopa therapy. Increasing oral doses to reduce OFF-time is often limited by peak-dose adverse effects, particularly dyskinesia. Continuous subcutaneous infusion of levodopa/carbidopa or foslevodopa/foscarbidopa offers a potential strategy to maintain stable dopaminergic levels and improve motor control.
Method: We systematically searched MEDLINE, Embase, CENTRAL, and ICTRP through January 2026 for clinical trials comparing subcutaneous infusions of levodopa or foslevodopa to standard oral levodopa in Parkinson’s disease. Key outcomes included daily OFF-time, health-related quality of life (PDQ-39), sleep quality (PDSS-2), and adverse events. Data were pooled using standard meta-analytic techniques, and study quality was assessed.
Results: Eight trials including 820 patients were analyzed, with 460 receiving subcutaneous levodopa/carbidopa (ND0612) and 360 receiving foslevodopa/foscarbidopa. Pooled analysis showed that subcutaneous infusion reduced daily OFF-time by 2.1 hours (p = 0.0003). Improvements were also seen in PDQ-39 scores (−3.8 points, p = 0.0004) and PDSS-2 sleep scores (−1.5 points, p = 0.03). Adverse events were more frequent in the infusion groups, mainly infusion-site reactions (p = 0.04). Overall evidence quality was moderate.
Conclusion: Subcutaneous infusion of levodopa/carbidopa or foslevodopa significantly decreases OFF-time in Parkinson’s disease, with modest benefits in quality of life and sleep. Infusion-site adverse events highlight the need for monitoring. Continuous subcutaneous therapy represents a promising approach to stabilizing motor function and improving patient experience.
To cite this abstract in AMA style:
K. Sarhan. Continuous Subcutaneous Levodopa Therapy Improves Motor Fluctuations and Quality of Life in Parkinson’s Disease: Evidence from Meta-analysis of Clinical Trials [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/continuous-subcutaneous-levodopa-therapy-improves-motor-fluctuations-and-quality-of-life-in-parkinsons-disease-evidence-from-meta-analysis-of-clinical-trials/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/continuous-subcutaneous-levodopa-therapy-improves-motor-fluctuations-and-quality-of-life-in-parkinsons-disease-evidence-from-meta-analysis-of-clinical-trials/