Objective: We want to present our results in Duodopa treatment for advanced Parkinson’s disease (PD).

Background: A center for advanced PD was created in our hospital in June 2013. This is a county hospital in a 600 000 people region.

Methods: In 2013 we formed a team for advanced Parkinson’s disease and developed our protocol for Duodopa treatment. All patients have a self-evaluation at admission. All patient were evaluated with scales for motor and non-motor aspects in PD.

Results: There are 12 patients that underwent this treatment and other 4 patients were tested but no percutaneous endoscopic gastrostomy with jejune tube introduction (PEGJ) was realized from June 2013: 2013 3 patients tested, 2 patients PEGJ performed, 2014: 7 patients tested and all PEGJ performed, 2015: 6 patients tested and 3 PEGJ performed. More patients were refereed to the center, but for most part of them the treatment were under dose, and in these situation the treatment were adapted. Some patients were with cognitive deterioration: medium or severe dementia and Duodopa treatment was no properly. Unfortunately, an important number of patients denied the PEGJ because varied motivation. Age of patients were 53-80 years, 83% were female. MMSE was more than 25 points. Disease onset was with 5 to 17 years ago. All patient were in Hoehen %Yahr IV stage at admission, all had have severe motor fluctuation with delayed on, no on, short on and wearing off phenomenon, on with dyskinesia and pain dystonia in off. All patients had multiple non-motor symptoms. Most frequent was depression with anxiety: 83%. Some patients had important comorbidities: 1 patient diabetes, 2 ischemic cardiovascular disease, 1 patient had a severe traumatic brain injury. After Duodopa initiation all patients were better from all points of view, with all evaluating scale. All patients become for nighttime levodopa forms with long-term action, and depression was treated. In time, one patient needed internal tube replacement for displacement reasons and 3 patients had tube occlusion and needed some maneuver for cleaning. Patients’ evolution was favorable in all cases. One of patients died with cardiac infarct in 4 months after PEGJ.

Conclusions: The results are encouraging. The clinical evolution of our patients motivates us to enhance this kind of treatment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/duodopa-treatment-experience-in-oradea/