Objective: To compare weight variations between three cohorts of patients with advanced Parkinson’s disease (PD): patients during their first year of treatment either with levodopa-carbidopa intestinal gel infusion (LCIG) or with subthalamic nucleus deep brain stimulation (STN-DBS), and patients with conventional oral therapy.

Background: Continuous infusion of LCIG, as well as STN-DBS are the treatment of levodopa motor complications in patients with advanced PD. While increase of weight is a well-known complication of STN-DBS, a loss of weight has been reported in some studies of patients with LCIG. However, the link between weight-loss and the disease, treatment and material remains unclear.

Methods: Weight variation and Body Mass Index (BMI) is studied retrospectively in 19 patients treated with LCIG. These patients were matched by gender, age (+/-4 years), duration of the disease (+/-3 years) and the Hoehn and Yahr ON scale to 18 STN-DBS patients (during the first year after surgery) and to 18 PD patients only treated with conventional oral therapy. Patients with metabolic disorders such as diabetes mellitus or cancer within the 5 years before baseline were excluded. Clinical features (weight, height, treatment, cognitive impairment, medical history, blood tests) were collected at baseline, 6 months and 12 months.

Results: The study showed a reduction of the mean weight in the LCIG group (5,78kg ± 6,8) during the first year after starting the treatment. Specifically, in 15 patients the weight decreased, in 2 patients it increased, 1 patient had to stop the treatment after 4 months, and another remained stable. The mean BMI decrease of the LCIG cohort was 2,1Kg/m²± 2,6 at 12 months. At a lesser degree, there was a decrease of weight and BMI (1,44kg ±3,14 and 0,55Kg/m²± 1,1) in the oral therapy cohort. In contrast and as expected, matched patients who underwent STN-DBS showed an increase of weight and BMI during the first year of treatment (5,45kg ± 4,7 and 1,97Kg/m²± 1,7).

Conclusions: LCIG treatment was associated with a risk of weight decrease higher than the one observed with the disease itself. Some patients experienced a severe loss of weight. Understanding its mechanisms is important to prevent malnutrition or vitamin deficiency which could participate to a poor quality of life and probably promote the occurrence of neuropathy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/weight-variation-in-parkinsons-disease-patients-treated-with-levodopa-carbidopa-intestinal-gel-infusion/