Session Information
Date: Tuesday, September 24, 2019
Session Title: Parkinsonisms and Parkinson-Plus
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To identify predictors of discontinuation of levodopa/carbidopa intestinal gel therapy.
Background: Although levodopa/carbidopa intestinal gel (LCIG) is an established treatment for Parkinson’s disease complicated by disabling motor fluctuations, there is little available data regarding its clinical use in the US. We report the experience of the Vanderbilt Movement Disorders Clinic (VMDC) with LCIG to identify risk factors for early discontinuation of therapy.
Method: We reviewed the records of all patients who were initiated on LCIG at VMDC between June 2015 and October 2018. Demographic data and use of concomitant medications were recorded. Comparisons were performed between patients who remained on LCIG during this period versus those who discontinued. Two-tailed t-tests were used for age comparisons, and chi-squared was used for the other analyses. These were not corrected for multiple comparisons.
Results: A total of 38 patients were included the analysis. A total of 13 (34%) discontinued LCIG during this period versus 25 (66%) who remained on LCIG. Of the 13 who discontinued, the average age at start of therapy was 71.9 (+/- 8.3) versus 62.8 (+/- 9.5) for those who remained on therapy (p<0.06). The average age at PD diagnosis was 59.5 (+/- 9.4) years in those who discontinued versus 65.8 (+/- 9.5) (p<0.05). The average disease duration was 12.2 (+/- 6.7) years versus 13.0 (+/- 7.7) (p<0.75). Of the 8 patients who were on antipsychotic therapy prior to starting LCIG therapy, 37% discontinued LCIG (ns). Of the 15 who were taking antidementia medications, 40% discontinued (ns). The discontinuation rate for women was 50% (5/10) versus 29% (8/28) for men (p<0.27).
Conclusion: In this small population, patients who were older at the time of PD diagnosis appeared more likely to discontinue LCIG therapy. Patients taking either antipsychotic or antidementia medications and patients with longer disease duration did not appear to discontinue LCIG therapy at a higher rate.
To cite this abstract in AMA style:
A. Nagy, T. Davis, T. Hassell, P. Hedera, D. Isaacs, H. Koons, F. Phibbs, S. Afrow, J. Fang. Predictors of Retention for Carbidopa/Levodopa Intestinal Gel in Parkinson Disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/predictors-of-retention-for-carbidopa-levodopa-intestinal-gel-in-parkinson-disease/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-retention-for-carbidopa-levodopa-intestinal-gel-in-parkinson-disease/