Objective: To describe clinical characteristics, treatment indications, safety profile, and treatment persistence in patients with advanced PD treated with continuous subcutaneous levodopa infusion.
Background: Continuous subcutaneous levodopa infusion with foslevodopa/foscarbidopa is an emerging advanced therapy for advanced Parkinson’s disease (PD). Although clinical trials have demonstrated its efficacy, real-world data regarding safety and treatment persistence remain limited.
Method: Retrospective observational study including 42 patients with advanced PD treated with continuous subcutaneous foslevodopa/foscarbidopa infusion. Demographic and clinical variables were collected, including age, disease duration, levodopa equivalent daily dose (LEDD), motor fluctuations, dyskinesias, motor phenotype, and previous advanced therapies.
Results: Mean age at treatment initiation was 72.6 ± 14.4 years, with a mean disease duration of 12.6 ± 5.38 years. Most patients had motor fluctuations (97.6%) and dyskinesias (71%), with predominance of the PIGD phenotype (61.9%). 45.2% of patients had previously received advanced therapies, mainly apomorphine infusion (60%) or deep brain stimulation (25%). The main indication for treatment initiation was uncontrolled motor fluctuations (54.8%), with a baseline mean of 7.53 daily OFF hours. Device-related complications were reported in 68.8%, most frequently subcutaneous nodules (51.9%). Other complications included dyskinesias (18.8%) and weight loss (6.7%), with a low hospitalization rate (3.2%). Treatment discontinuation occurred in 22.9%, with a median time to withdrawal of 52 days.
Conclusion: In our cohort, the subcutaneous levodopa/carbidopa infusion pump appears to be a valuable therapeutic option for patients with advanced PD characterized by long disease duration, high levodopa equivalent doses, and motor fluctuations. The high proportion of patients previously treated with other advanced therapies suggests a potential role for this therapy as a rescue option in selected patients. The relatively advanced age of our cohort suggests that this therapy may represent a valuable option for patients who are not candidates for surgical therapies. Although local complications are relatively frequent, the overall safety profile appears favorable and most patients remain on treatment.
References: Santos-García D, Solleiro Á, González-Ortega G, Mir P, López-Ariztegui N, García Ramos R, Legarda I, Planas-Ballvé A, Alonso-Modino D, Sánchez-Alonso P, Cabo I, Blázquez-Estrada M, Sánchez-Ferro Á; DATs‐PD GETM Spanish Registry Group. Profile of People With Parkinson’s Disease Treated With a Device-Aided Therapy in Spain. A Comparative Multicenter Observational Study. Mov Disord Clin Pract. 2026 Jan;13(1):154-172. doi: 10.1002/mdc3.70239. Epub 2025 Jul 24. PMID: 40704401; PMCID: PMC12839489.
To cite this abstract in AMA style:
P. Prendes Fernandez, P. Tartiere Gonzalez, E. Suarez Sanmartin, C. Garcia Fernandez, L. Gonzalez Alvarez, M. Blazquez Estrada. Continuous subcutaneous levodopa infusion in advanced Parkinson’s disease: a descriptive real-world cohort study [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/continuous-subcutaneous-levodopa-infusion-in-advanced-parkinsons-disease-a-descriptive-real-world-cohort-study/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/continuous-subcutaneous-levodopa-infusion-in-advanced-parkinsons-disease-a-descriptive-real-world-cohort-study/