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 describe adverse events (AEs) associated with levodopa-carbidopa intestinal gel (LCIG) treatment and the main reasons for treatment discontinuation. We also assessed the effectiveness of and satisfaction with LCIG.
Background: Treatment with LCIG can effectively relieve motor and non-motor symptoms in advanced Parkinson’s disease (PD). However, AEs are frequent.
Method: We retrospectively analyzed data on AEs in patients treated with LCIG at a French university medical center over a 13 year-period. For patients still receiving treatment at last follow-up, effectiveness was assessed according to the Clinical Global Impression (CGI) scale.
Results: Of the 63 patients (mean duration of the disease: 15.3 years) treated with LCIG for a mean (range) of 19 months (8‒47), 57 (90%) experienced at least one AE (340 AEs in total). Most of the AEs (in 69.8% of the patients) were related to percutaneous endoscopic gastrostomy with a jejunal tube (PEG-J) or affected the gastrointestinal tract (granuloma, leakage, or a local infection). Device-related AEs (such as PEG-J removal and device occlusion) were frequent (in 63.5% of patients). Forty-three patients (68%) required at least one additional endoscopic procedure, PEG-J replacement in 29 patients (46%) and jejunal tube replacement in 24 (38%). Dopatherapy-related AEs occurred in 30 patients (48%), such as hallucinations and orthostatic hypotension. Chronic polyneuropathy was diagnosed in 10 patients (15.9%). Most of the AEs occurred long after treatment initiations, and only a small proportion led to discontinuation. 32 patients were assessed at last follow-up. On the CGI scale, 27 patients (84.4%) considered that their condition had improved during LCIG treatment.
Conclusion: Despite the high frequency of AEs and the evolution of the disease, patients with advanced PD gain clinical benefit from treatment with LCIG. Most of the AEs are mild or moderate, and easily managed. For optimal results, access to a multidisciplinary team with experience in the use of the PEG-J is essential.
To cite this abstract in AMA style:
A-S. Blaise, G. Baille, N. Carrière, D. Devos, K. Dujardin, G. Grolez, A. Kreisler, M. Kyheng, C. Moreau, E. Mutez, D. Seguy, L. Defebvre. Safety and effectiveness of levodopa-carbidopa intestinal gel for advanced Parkinson’s disease : a large single-center study [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/safety-and-effectiveness-of-levodopa-carbidopa-intestinal-gel-for-advanced-parkinsons-disease-a-large-single-center-study/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/safety-and-effectiveness-of-levodopa-carbidopa-intestinal-gel-for-advanced-parkinsons-disease-a-large-single-center-study/