PMID- 34172002 OWN - NLM STAT- MEDLINE DCOM- 20210719 LR - 20210719 IS - 1471-2377 (Electronic) IS - 1471-2377 (Linking) VI - 21 IP - 1 DP - 2021 Jun 25 TI - The impact of tube replacement timing during LCIG therapy on PEG-J associated adverse events: a retrospective multicenter observational study. PG - 242 LID - 10.1186/s12883-021-02269-7 [doi] LID - 242 AB - BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) treatment, a unique drug delivery system for patients with advanced Parkinson's disease (PD), is covered by health insurance in Japan since September 2016. Various LCIG procedure/device-associated adverse events (AEs) have been reported; however, reports on their treatment have been limited. This is the first multicenter study to clarify the frequency and timing of device-related AEs. METHODS: Between September 2016 and December 2018, 104 patients introduced to the LCIG treatment for advanced PD in 11 hospitals were included. The patients' characteristics, AEs incidence, AEs time, and tube exchange time were investigated. RESULTS: The median follow-up period was 21.5 months. Minor AE cases were 29.4%, whereas major AE cases were 43.1%. Majority of major AEs (n = 55, 94.8%) were managed with endoscopic treatment, such as tube exchange. Few severe AEs required surgical treatment (n =3, 5.2%). The mean (range) exposure to percutaneous endoscopic gastrojejunostomy (PEG-J) was 14.7 (0-33) months. One year after the LCIG treatment introduction, 55 patients (54.0%) retained the original PEG-J tube. The mean PEG-J tube exchange time was 10.8 +/- 7.0 months in all patients, 11.6 +/- 4.7 and 10.5 +/- 7.7 months in patients with scheduled exchange and who underwent exchange due to AEs, respectively. CONCLUSIONS: Some device-related AEs occurred during the LCIG treatment; however, only few were serious, most of which could be treated with simple procedures or tube replacement with endoscopy. Therefore, the LCIG treatment is feasible and safe and is a unique treatment option for PD, requiring endoscopists' understanding and cooperation. FAU - Yamashita, Kanefumi AU - Yamashita K AD - Department of Gastroenterological Surgery, Seizan-Kai Kawaminami Hospital, Kawaminami-cho, Kawaminami 18150-47, Koyu-gun, Miyazaki, 889-1301, Japan. kanefumi0519@yahoo.co.jp. FAU - Yube, Yukinori AU - Yube Y AD - Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, Tokyo, Japan. FAU - Yamazaki, Yukinao AU - Yamazaki Y AD - Department of Gastroenterology, Fukui Red Cross Hospital, Fukui, Japan. FAU - Fukuchi, Takehide AU - Fukuchi T AD - Division of Endoscopy, Yokohama City University Medical Center, Kanagawa, Japan. FAU - Kato, Masaki AU - Kato M AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan. FAU - Koike, Tomoyuki AU - Koike T AD - Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan. FAU - Uehara, Takeshi AU - Uehara T AD - Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, Saitama, Japan. FAU - Ikeda, Yoshiou AU - Ikeda Y AD - Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan. FAU - Furune, Satoshi AU - Furune S AD - Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Murakami, Hidehiro AU - Murakami H AD - Department of Internal Medicine, Saiseikai Matsuyama Hospital, Ehime, Japan. FAU - Kubota, Eiji AU - Kubota E AD - Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. FAU - Fujioka, Shinsuke AU - Fujioka S AD - Department of Neurology, Fukuoka University, Fukuoka, Japan. FAU - Sato, Yoshinori AU - Sato Y AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan. FAU - Jin, Xiaoyi AU - Jin X AD - Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan. FAU - Suzuki, Tomohiko AU - Suzuki T AD - Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Furukawa, Kazuhiro AU - Furukawa K AD - Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. FAU - Tsuboi, Yoshio AU - Tsuboi Y AD - Department of Neurology, Fukuoka University, Fukuoka, Japan. LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20210625 PL - England TA - BMC Neurol JT - BMC neurology JID - 100968555 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 - *Antiparkinson Agents/administration & dosage/adverse effects/therapeutic use MH - *Carbidopa/administration & dosage/adverse effects/therapeutic use MH - Drug Combinations MH - *Gastric Bypass/adverse effects/methods MH - *Gels/administration & dosage/adverse effects/therapeutic use MH - Humans MH - *Levodopa/administration & dosage/adverse effects/therapeutic use MH - Parkinson Disease/*drug therapy MH - Retrospective Studies PMC - PMC8228941 OTO - NOTNLM OT - Levodopa-carbidopa intestinal gel OT - Parkinson's disease OT - Percutaneous endoscopic gastrojejunostomy COIS- The authors have no conflict of interest to declare. EDAT- 2021/06/27 06:00 MHDA- 2021/07/20 06:00 PMCR- 2021/06/25 CRDT- 2021/06/26 05:25 PHST- 2021/02/15 00:00 [received] PHST- 2021/06/03 00:00 [accepted] PHST- 2021/06/26 05:25 [entrez] PHST- 2021/06/27 06:00 [pubmed] PHST- 2021/07/20 06:00 [medline] PHST- 2021/06/25 00:00 [pmc-release] AID - 10.1186/s12883-021-02269-7 [pii] AID - 2269 [pii] AID - 10.1186/s12883-021-02269-7 [doi] PST - epublish SO - BMC Neurol. 2021 Jun 25;21(1):242. doi: 10.1186/s12883-021-02269-7.