Objective: To investigate the long-term effect of levodopa-carbidopa intestinal gel (LCIG) on axial signs in Parkinson’s disease (PD) patients and the related prognostic factors.

Background: Few short-mild-temr studies (up to 24 months) have suggested that LCIG may have a benefit on PD axial signs.

Method: A retrospective study on 49 PD patients treated with LCIG. Axial signs as per the Unified Parkinson disease rating scale  axial  score (AS), Hoehn & Yahr (H&Y) scale and levodopa equivalent daily dose (LEDD) were assessed at baseline (before starting LCIG treatment) and at the last follow-up (FU).

Results: After 47.6 ± 30 months of treatment, total AS deteriorated while motor complications still improved, in spite of a significant LEDD/Kg increment (Table 1). When adjusted for LCIG treatment duration, a higher AS and freezing of gait (FOG) severity at FU were predicted by a baseline lower response to L-dopa and higher HY (p<0.01) and they were related to a lower independency in activity of daily life at FU (p<0.001).  Axial score and FOG progression, stratified per FU time and baseline HY values are described in Figure 1. Single axial items remain stable up to one year and postural instability up to four years.

Conclusion: Baseline disease severity and the magnitude of L-dopa response predict axial signs severity after around four years of LCIG treatment, with consequent implication on patients’ functional independence.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effect-of-levodopa-carbidopa-intestinal-gel-on-axial-signs-in-parkinsons-disease/