Objective: To reduce the risk of adverse events and dropout rate in patients.

Background: Duodenal levodopa infusion (DLI) is used for the treatment of advanced Parkinson’s disease (PD). DLI efficacy and safety has been proved and risks for its withdrawal are due to the procedure, the device or the therapy related causes. To minimize procedure and device related risk of withdrawal is crucial.

Methods: Clinical data on eleven PD patients treated with DLI at our centre over a 6-year period were retrieved and analysed to determine duration of treatment, number of adverse events reported, neurological interventions and PEG substitutions performed.

Results: Mean DLI duration was 24,27±18,59 months (min 0 – max 62), neurological evaluations have been performed every 1,26±1,42 months (min 0 – max 8) on each patient. Most common causes of PEG-J replacement interventions (tot. 27), were: normal tear and wear (6) and internal bumper deterioration (5); mean PEG-J replacement for patient was 2,36±1,96 times (min 0 – max 6). Mean PEG-J duration was 9,04±7,18 months (0 min – max 27). Peristomal skin infections (4 cases) and malnutrition (4 cases) were the most common adverse events. No serious adverse events have been reported. Of the 11 patients, 3 subjects died of causes unrelated to DLI infusion and none discontinued therapy.

Conclusions: In line with the literature, DLI is confirmed to be safe and effective. Nevertheless, treatment discontinuation is frequent (32,5 and 38,8% respectively). In our study, a short-term multidisciplinar follow-up with prompt clinical evaluations, sets the dropout rate to zero.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/duodenal-levodopa-infusion-safety-and-efficacy-in-a-6-years-outpatient-follow-up/