Objective: To investigate the occurrence of weight loss (WL) in Parkinson’s disease (PD) patients under LCIG treatment and to analyse its relationship with the nutritional status and relevant clinical variables.

Background: WL has been suggested as a biomarker of disease progression for PD [1]. WL is a frequent adverse event among PD patients under levodopa/carbidopa intestinal gel (LCIG) treatment [2]. However nor its prevalence neither its causes have been systematically analyzed.

Methods: A cross-sectional study was performed among PD patients currently under LCIG treatment at our Center for at least six months. The body weight, the Mini Nutritional assessment (MNA) and the Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q) were evaluated and correlated with relevant clinical variables acquired during the Hospital visit (T1) and retrospectively before starting LCIG (T0) [(MDS-UPDRS, Mini Mental State Examination, Beck Depression Inventory Scale, Hoehn Yahr (HY) Stage, Schwab and England ADL Scale (SE) and levodopa equivalent daily dose (LEDD)].

Results: We recruited 44 patients with a mean ± SD age and disease duration of 71.7 ± 6.6 and 18.3 ± 6.5 years, respectively [Table 1]. After an average of 51.6 ± 28.5 months of LCIG treatment, patients had lost 9.9 ± 10.5% of their baseline body weight. Sixteen patients (36%) had lost > 10Kg [Table 1]. The percentage of WL significantly correlated with dyskinesia duration and delta BMI (p< 0.05) whereas the nutritional status of patients under LCIG treatment as per MNA correlated with HY stage (p =0.012), dysphagia, MDS-UPDRS-III, EdFED-Q and LEDD/Kg (p<0.01) [Table 2].

Conclusions: WL is a common event among PD patients treated with LCIG. We found that the extent of dyskinesia and LEDD were the most relevant factors correlated to its occurrence. The nutritional status of PD patients under long-term LCIG treatment is primarily related to disease severity and the presence of dysphagia. Periodic nutritional assessments are strongly recommended in these patients.

References: [1] A.M. Wills, A. Perez, J. Wang, X. Su, J. Morgan, S.S. Rajan, M.A. Leehey, G.M. Pontone, K.L. Chou, C. Umeh, Z. Mari, J. Boyd, Association Between Change in Body Mass Index, Unified Parkinson’s Disease Rating Scale Scores, and Survival Among Persons With Parkinson Disease: Secondary Analysis of Longitudinal Data From NINDS Exploratory Trials in Parkinson Disease Long-term Study 1, JAMA neurology 73(3) (2016) 321-8. [2] M. Zibetti, A. Merola, C.A. Artusi, L. Rizzi, S. Angrisano, D. Reggio, C. De Angelis, M. Rizzone, L. Lopiano, Levodopa/carbidopa intestinal gel infusion in advanced Parkinson’s disease: a 7-year experience, European journal of neurology : the official journal of the European Federation of Neurological Societies 21(2) (2014) 312-8.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/weight-loss-and-nutritional-status-in-parkinsons-disease-patients-under-levodopa-carbidopa-intestinal-gel-infusion-treatment/