PMID- 30562907
OWN - NLM
STAT- MEDLINE
DCOM- 20200520
LR  - 20200520
IS  - 1877-718X (Electronic)
IS  - 1877-7171 (Linking)
VI  - 9
IP  - 1
DP  - 2019
TI  - Impact of Disease Duration in Effectiveness of Treatment with Levodopa-Carbidopa 
      Intestinal Gel and Factors Leading to Discontinuation.
PG  - 173-182
LID - 10.3233/JPD-181324 [doi]
AB  - BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is effective in the 
      treatment of advanced Parkinson's disease (PD). However, the patients' profile 
      that might benefit from treatment with LCIG has not been characterized. 
      OBJECTIVE: This retrospective study explored the influence of disease duration 
      (DD) on the effectiveness of LCIG and identified factors associated with 
      treatment discontinuation in a cohort of advanced PD patients. METHODS: Patients 
      initiating LCIG therapy between Jan-2006 and Dec-2011 in 18 Spanish centers were 
      included. Effectiveness in treating motor symptoms (MSs), non-motor symptoms 
      (NMSs), and adverse events (AEs) occurrence was compared in DD>/=10 or <10 years 
      and LCIG continuation/discontinuation groups. Factors associated with LCIG 
      discontinuation were evaluated using univariate and multivariate analyses. 
      RESULTS: Overall, 177 PD patients were included (52.5% male; mean age 70.6+/-8.4 
      years; mean LCIG duration 35.6+/-18.6 months). Patients with DD>/=10 years (n = 125) 
      experienced less reduction in "off" time (-29%) than those with DD <10 years 
      (-38%; n = 51; p = 0.021), and reported more severe AEs (32.8% vs. 17.6%; 
      p = 0.043). DD did not significantly influence changes in NMSs or discontinuation 
      rates. Fifty-four patients discontinued LCIG therapy, factors associated with 
      discontinuation were higher percentages of waking day in the "off" state (OR, 
      1.028; 95% CI, 1.002-1.055; p = 0.0360) and in the "on" state with troublesome 
      dyskinesia (OR, 1.032; 95% CI, 1.002-1.064; p = 0.0376) at baseline. CONCLUSIONS: 
      Advanced PD patients with DD <10 years might benefit more from treatment with 
      LCIG than patients with a longer DD. Although MSs severity at baseline was 
      statistically associated with LCIG discontinuation, the probability was very low 
      with little clinical significance.
FAU - Regidor, Ignacio
AU  - Regidor I
AD  - Functional Neurosurgery Unit, Hospital Universitario Ramon y Cajal, Madrid, 
      Spain.
FAU - Santos-Garcia, Diego
AU  - Santos-Garcia D
AD  - Department of Internal Medicine, Neurology Section, Hospital Arquitecto Marcide, 
      Complejo Hospitalario Universitario de Ferrol (CHUF), A Coruna, Spain.
FAU - Catalan, Mar Ia Jose
AU  - Catalan MIJ
AD  - Department of Neurology, Movement Disorders Unit, Hospital Clinico San Carlos, 
      Madrid, Spain.
FAU - Puente, Victor
AU  - Puente V
AD  - Department of Neurology, Movement Disorders Unit, Parc de salut Mar, Institut 
      Hospital del Mar d'investigacions Medicas, Universitat Autonoma de Barcelona, 
      Barcelona, Spain.
FAU - Valldeoriola, Francesc
AU  - Valldeoriola F
AD  - Department of Neurology, Movement Disorders Unit, Hospital Clinic, Barcelona, 
      Spain.
FAU - Grandas, Francisco
AU  - Grandas F
AD  - Department of Neurology, Hospital General Universitario Gregorio Maranon, Madrid, 
      Spain.
FAU - Mir, Pablo
AU  - Mir P
AD  - Department of Neurology, Movement Disorders Unit, Instituto de Biomedicina de 
      Sevilla, Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, 
      Seville, Spain.
AD  - Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas 
      (CIBERNED), Madrid, Spain.
FAU - Parra, Juan Carlos
AU  - Parra JC
AD  - AbbVie Spain S.L.U., Madrid, Spain.
FAU - Arbelo, Jose Matias
AU  - Arbelo JM
AD  - Department of Neurology, Hospital Universitario Insular de Gran Canaria, Las 
      Palmas de Gran Canaria, Spain.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - J Parkinsons Dis
JT  - Journal of Parkinson's disease
JID - 101567362
RN  - 0 (Antiparkinson Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (Gels)
RN  - 0 (carbidopa, levodopa drug combination)
RN  - 46627O600J (Levodopa)
RN  - MNX7R8C5VO (Carbidopa)
SB  - IM
MH  - Aged
MH  - Antiparkinson Agents/administration & dosage/adverse effects/*pharmacology
MH  - Carbidopa/administration & dosage/adverse effects/*pharmacology
MH  - Drug Combinations
MH  - *Drug-Related Side Effects and Adverse Reactions
MH  - Female
MH  - Gels
MH  - Humans
MH  - Infusions, Parenteral
MH  - Levodopa/administration & dosage/adverse effects/*pharmacology
MH  - Male
MH  - Middle Aged
MH  - Parkinson Disease/*drug therapy
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Time Factors
OTO - NOTNLM
OT  - Parkinson's disease
OT  - global clinical impression
OT  - levodopa-carbidopa intestinal gel
OT  - non-motor symptoms
EDAT- 2018/12/20 06:00
MHDA- 2020/05/21 06:00
CRDT- 2018/12/20 06:00
PHST- 2018/12/20 06:00 [pubmed]
PHST- 2020/05/21 06:00 [medline]
PHST- 2018/12/20 06:00 [entrez]
AID - JPD181324 [pii]
AID - 10.3233/JPD-181324 [doi]
PST - ppublish
SO  - J Parkinsons Dis. 2019;9(1):173-182. doi: 10.3233/JPD-181324.