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Intrajejunal levodopa infusion (ILI) for Parkinson’s Disease (PD): A Canadian Experience

P. Podgorny, P. McCann, K. Toore, G. Tremain, A. Lazarescu, O. Suchowersky (Edmonton, AB, Canada)

Meeting: 2017 International Congress

Abstract Number: 708

Keywords: Levodopa(L-dopa), Pharmacotherapy

Session Information

Date: Tuesday, June 6, 2017

Session Title: Therapy in Movement Disorders

Session Time: 1:45pm-3:15pm

Location: Exhibit Hall C

Objective: To review the benefits and complications of ILI for PD in a tertiary movement disorders center in Canada.

Background: ILI has been in use in Canada since 2011 to treat advanced PD, typically when oral medications are no longer tolerated due to increasing dyskinesias and/or ‘OFF times’. Long term outcomes in this patient population have not yet fully been elucidated. In Edmonton, ILI is executed by a multidisciplinary team including a neurologist, gastroenterologist, and a specialized nurse.

Methods: We performed a detailed chart review of all patients that have to-date been treated with ILI at our center. Information extracted included motor UPDRS scores, endoscopic reports, ILI pump and PEG-J tube complications. Additionally, patients and caregivers were interviewed at regular clinic follow up about their subjective experience with ILI, including overall satisfaction and complaints.

Results: 13 patients have received ILI [10M, 3F; mean age 65.6 yrs, range (51.8-79.5), PD duration 14.2yrs, range (9.1-22.0), mean follow-up 1.8yrs, range (0.2-4.8)]. Patients commonly reported improvement in motor function, decreased dyskinesias and ‘OFF times’ [mean motor UPDRS scores: pre-ILI 37.1, 1-6months post-ILI 27.5]; improvement persisted for the majority of patients. One patient noted return of sense of smell. Common complications included dislodgement, knotting or blockage of the jejunal tube extension requiring endoscopic re-insertion; 29 such incidents occurred across 6 patients in 5 years. Four patients discontinued Duodopa treatment, for reasons of declining cognition, inability to care for the pump, and/or minimal benefit. One patient died from unrelated causes.

Conclusions: The University of Alberta Hospital in Edmonton was the first center in Canada to enroll a patient in ILI therapy, under a research protocol; it is now available as a standard of practice. ILI is useful for the treatment of advanced PD, in patients that can care for the pump apparatus. The most common complication is jejunal tube displacement.

To cite this abstract in AMA style:

P. Podgorny, P. McCann, K. Toore, G. Tremain, A. Lazarescu, O. Suchowersky. Intrajejunal levodopa infusion (ILI) for Parkinson’s Disease (PD): A Canadian Experience [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/intrajejunal-levodopa-infusion-ili-for-parkinsons-disease-pd-a-canadian-experience/. Accessed May 23, 2025.
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