Objective: To evaluate efficacy, safety, and discontinuation rates of FLC/FCD in a retrospective cohort of advanced PD patients.

Background: Continuous subcutaneous FLC/FCD is a novel 24-hour levodopa delivery system for advanced Parkinson’s disease (PD) with motor fluctuations. Real world data outside clinical trials remain limited.

Method: Twenty-eight patients with advanced PD were included in this retrospective cohort study. Patients were selected for infusion therapy due to high levodopa requirements with persistent motor fluctuations and wearing-off, intolerance to oral levodopa, or unsuitability for deep brain stimulation. Continuous subcutaneous FLC/FCD was initiated during inpatient titration. Motor and non-motor outcomes were assessed at baseline and at 6-month follow-up.

Results: Of 28 patients, 11 (39%) were female and 17 (61%) male. Mean age was 61.3 ± 13.5 years, disease duration 10.1 ± 7.4 years, and baseline LEDD 1018 ± 574 mg/day. Mean titration was 5.1 days. Daily OFF time decreased from 2.8 ± 1.4 to 0.9 ± 0.6 hours/day (p < 0.001), and ON-good time increased from 13.1 ± 1.4 to 15.1 ± 0.6 hours/day (p < 0.001). MDS-UPDRS Part III (ON) improved from 50.7 ± 14.4 to 27.1 ± 13.6 (−23.6 points, p < 0.001) and Hoehn & Yahr stage from 3.2 ± 0.9 to 2.0 ± 0.9 (p < 0.001). Non-motor symptoms decreased from 61.8 ± 26.2 to 31.4 ± 22.5 (p = 0.0007), and MDS-UPDRS I+II from 45.4 ± 20.2 to 22.6 ± 19.8 (p = 0.001). Six patients (21.4%) discontinued therapy, mainly due to infusion-site reactions (78.6%). Among continuers (n = 22), satisfaction was 95%.

Conclusion: Continuous subcutaneous FLC/FCD led to robust improvements in motor fluctuations, motor function, and non-motor burden in advanced PD, with discontinuation primarily related to infusion-site adverse events

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MDS Abstracts - https://www.mdsabstracts.org/abstract/real-world-experience-with-continuous-subcutaneous-foslevodopa-foscarbidopa-flc-fcd-in-advanced-parkinsons-disease-a-single-centre-cohort-study/