Problems related to levodopa-carbidopa intestinal gel treatment in advanced Parkinson's disease

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http://hdl.handle.net/10138/211811

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Udd , M , Lyytinen , J , Eerola-Rautio , J , Kenttämies , A , Lindström , O , Kylänpää , L & Pekkonen , E 2017 , ' Problems related to levodopa-carbidopa intestinal gel treatment in advanced Parkinson's disease ' , Brain and Behavior , vol. 7 , no. 7 , 00737 . https://doi.org/10.1002/brb3.737

Title: Problems related to levodopa-carbidopa intestinal gel treatment in advanced Parkinson's disease
Author: Udd, Marianne; Lyytinen, Jukka; Eerola-Rautio, Johanna; Kenttämies, Anu; Lindström, Outi; Kylänpää, Leena; Pekkonen, Eero
Contributor: University of Helsinki, University of Helsinki
University of Helsinki, Department of Neurosciences
University of Helsinki, University of Helsinki
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, University of Helsinki
University of Helsinki, Department of Surgery
University of Helsinki, HUS Neurocenter
Date: 2017-07
Language: eng
Number of pages: 7
Belongs to series: Brain and Behavior
ISSN: 2162-3279
URI: http://hdl.handle.net/10138/211811
Abstract: Background: Continuous levodopa-carbidopa intestinal gel (LCIG) diminishes daily off time and dyskinesia in patients with advanced Parkinsons disease (PD). Complications are common with percutaneous endoscopic gastrostomy with a jejunal extension tube (PEG-J). Aim of the Study: To report the clinical outcome of LCIG in patients with advanced PD in the years 2006-2014 at Helsinki University Hospital. Patients and Methods: Levodopa-carbidopa intestinal gel treatment started following PEG-J placement in patients with advanced PD after successful in-hospital LCIG trial with a nasojejunal tube. Demographics, PEG-J procedures, discontinuation of LCIG, complications and mortality were retrospectively analyzed. Results [mean (SD)]: Sixty patients with advanced PD [age 68(7) years; duration of PD: 11(4) years] had LCIG treatment for 26(23) months. The majority of patients with advanced PD were satisfied with the LCIG treatment. For 51 patients (85%), the pump was on for 16hr a day, and for nine patients (15%) it was on for 24hr a day. After 6months, the levodopa-equivalent daily dose (LEDD) had increased by 30% compared to pre-LCIG LEDD. Sixty patients underwent a total of 156 PEG-J procedures, and 48 patients (80%) had a total of 143 complications. Forty-six patients (77%) had 119 PEG-J or peristomal complications, and 22 patients (37%) had a total of 25 other complications. The most common complications were accidental removal of the J-tube in 23 patients (38%) and 5% weight loss in 18 patients (30%). Fifteen patients discontinued the LCIG after 21 (21) months. At the end of the follow-up period of 33(27) months, 38 patients were still on LCIG and nine (15%) had died. Conclusion: Most patients were satisfied with LCIG treatment. A few patients lost weight whereas the majority had complications with PEG-J. When LCIG treatment is carried out, neurological and endoscopic units must be prepared for multiple endoscopic procedures.
Subject: complication
duodopa
LCIG
mortality
Parkinson's disease
PEG-J
weight loss
LONG-TERM
OPEN-LABEL
ROUTINE CARE
INFUSION
SAFETY
MOTOR
GASTROSTOMY
12-MONTH
OUTCOMES
3112 Neurosciences
3124 Neurology and psychiatry
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