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Title: Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?
Author: Catalán Alonso, Maria José
Antonini, Angelo
Calopa Garriga, Matilde
Bajenaru, Ovidiu
Fàbregues, Oriol de
Mínguez Castellanos, Adolfo
Odin, Per
García Moreno, José Manuel
Pedersen, Stephen W.
Pirtosek, Zvezdan
Kulisevsky Bojarski, Jaume  
Others: Hospital Clínico San Carlos
IRCCS Ospedale San Camillo
Hospital Universitari de Bellvitge
Carol Davila University of Medicine and Pharmacy
Vall d'Hebron Barcelona Hospital Campus
Complejo Hospitalario Universitario de Granada
Lund University
Hospital Universitario Virgen Macarena
University of Copenhagen
University Medical Centre Ljubljana
Universitat Oberta de Catalunya
Keywords: non-motor symptoms
Parkinson's disease
Intrajejunal infusion of levodopa/carbidopa
intestinal gel
motor symptoms
quality of life
Issue Date: 2-Jul-2017
Publisher: eNeurologicalSci
Citation: Catalán, M.J., Antonini, A., Calopa, M., Bajenaru, O., Fàbregues, O. de, Mínguez-Castellanos, A., Odin, P., García-Moreno, J.M., Pedersen, S., Pirtosek, Z. & Kulisevsky, J. (2017). Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?. eNeurologicalSci, 8(), 44-53. doi: 10.1016/j.ensci.2017.06.004
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Abstract: Advanced Parkinson's disease (APD) is characterized by increased functional disability, caused by motor complications, the presence of axial symptoms, and emergent disease- and drug-related non-motor symptoms. One of the advanced therapies available is intrajejunal infusion of levodopa/carbidopa intestinal gel (LCIG); however, patient selection for this treatment is sometimes difficult, particularly because of overlapping indications with other alternatives. In recent years, strong evidence has supported the use of LCIG in treating motor fluctuations associated with APD, and several clinical studies provide emerging evidence for additional benefits of LCIG treatment in certain patients. This article provides an overview of the published literature on the benefits, limitations, and drawbacks of LCIG in relation to PD symptoms, the psychosocial impact of the disease, and the quality of life of patients, with the aim of determining candidates for whom treatment with LCIG would be beneficial. According to current evidence, patients with APD (defined as inability to achieve optimal control of the disease with conventional oral treatment), a relatively well-preserved cognitive-behavioral status, and good family/caregiver would count as suitable candidates for LCIG treatment. Contraindications in the opinion of the authors are severe dementia and active psychosis.
Language: English
ISSN: 2405-6502MIAR
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