Objective: To assess the tolerability and effect of levodopa-carbidopa intestinal gel (LCIG, designated in the United States as carbidopa-levodopa enteral suspension) on activities of daily living (ADL) in advanced Parkinson’s disease (PD) patients with troublesome motor fluctuations.

Background: LCIG is continuously delivered via percutaneous gastrojejunostomy (PEG-J) in advanced PD patients with motor fluctuations and dyskinesia not adequately reduced by available oral anti-Parkinsonian medications.

Methods: This multinational (7 countries, 35 centres) post-marketing observational study included advanced PD patients characterised by either 2-4 hours “off” time or 2 hours of dyskinesia daily, supported by a Unified Parkinson’s disease Rating Scale (UPDRS) Total Score of ≥40 at baseline. LCIG was titrated via a nasojejunal (NJ) tube, then administered via PEG-J for 12 months. ADL and quality of life were assessed by the UPDRS Part II total score and 8-item Parkinson’s disease Questionnaire (PDQ-8) summary index, respectively. Adverse events (AEs) were collected.

Results: Sixty-five patients were enrolled, 58 out of 64 patients (91%) who were treated with LCIG via NJ continued treatment via PEG-J (1 discontinued before titration), and 41 completed the study. At baseline, patients had PD for a mean of 13.9 years (Table 1). Patients had improvements in activities of daily living in the first 6 months and at final (Figure 1), and in quality of life (PDQ-8 summary index) at every time point. One-third of patients had an AE (Table 2), of which, 8 (12.5%) had an AE with a reasonable possibility of being related to LCIG, as rated by the study investigator.