Objective: To determine the long-term outcomes of levodopa/carbidopa intestinal gel infusion (LCIG) in advanced Parkinson’s disease (PD) patients.

Background: LCIG was introduced in the Netherlands in 2005. Since then, approximately 500 Dutch PD patients received this therapy. Although there is ample evidence of the short-term advantages of this treatment, long-term efficacy and safety data are scarce.

Methods: We retrospectively reviewed long-term outcomes of LCIG in a Dutch cohort of 500 PD patients in total. The first data of 2 centers are presented here. Our primary objective was to determine the overall treatment duration. The secondary objectives were to analyze reasons of withdrawal, the number of complications, and possible risk factors for discontinuation of LCIG treatment.

Results: The cohort from the 2 centers so far consists of 99 patients (baseline characteristics: age: 66.2 ± 8.2 years; disease duration: 12.5 ± 5.4; ≥ 1 comorbidities: 45.4%). Prior to the start of LCIG, 29 patients had been treated with another advanced therapy (subcutaneous apomorphine (n = 24), deep brain stimulation (n = 1) or both (n = 4)). The median treatment duration, as computed by Kaplan-Meier analysis, was 7.17 ± 0.35 years, ranging up to 9.3 years. A total number of 26 patients stopped with LCIG during follow-up. The main reasons for discontinuation were death (n = 7), side effects related to the LCIG tube (n = 5; e.g. tube dislocations), or efficacy being less than expected by the patient (n = 5). Overall, 76 patients experienced in total 245 complications, whereas 33 patients needed hospitalization. Multiple logistic regression showed that discontinuation was negatively associated with disease duration (OR = 0.88; 95% CI: 0.79-0.98) and positively associated with the number of complications for which hospitalization was needed (OR = 2.07; 95% CI: 1.21-3.55).

Conclusions: LCIG is very well tolerated during long-term follow-up. Shorter disease duration at baseline and treatment complications needing hospitalization were associated with the risk of discontinuing LCIG.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effects-of-levodopacarbidopa-intestinal-gel-infusion-in-advanced-parkinsons-disease-patients-dutch-multicenter-retrospective-cohort-study/