Objective: To compare costs and effectiveness of the therapies DBS and CLI in advanced PD.

Background: The therapies deep brain stimulation (DBS) and continuous intrajejunale levodopa infusion (CLI) both are efficacious treatments of motor symptoms in advanced Parkinson’s disease (PD). They reduce medication induced motor fluctuations and dyskinesias. Moreover, they significantly improve quality of life. The costs of CLI seem higher. Yet, comparative knowledge with respect to effectiveness, complications and costs is lacking as a randomized controlled trial (RCT) comparing DBS and CLI has never been performed. As a result, there is unwanted variation in medical practice regarding treatment of advanced PD.

Methods: A prospective open label multicentre RCT is currently performed. A total of 66 PD patients with medication induced motor fluctuations will be randomised between DBS and CLI treatment. Patients not willing to be randomised are eligible for an observational patient-preference study. There are 6 assessment visits in the first year of treatment. The primary health economic outcomes are costs per unit on the quality of life scale PDQ-39 and costs per QALY (Quality Adjusted Life Years) at 12 months. Major secondary outcomes are quality of life, functional health and complications.

Results: The study started in December 2014, results are expected in 2019.

Conclusions: The INVEST study is the first randomized study to provide comparative knowledge on the therapies DBS and CLI in advanced PD.

Poster presentation on study design at XXI World Congress on Parkinson’s disease and Related Disorders, December 8th, Milan, Italy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-comparison-of-deep-brain-stimulation-and-continuous-intrajejunal-levodopa-infusion-in-advanced-parkinsons-disease-the-invest-study/