2024-03-29T07:17:52Zhttp://digital.csic.es/dspace-oai/requestoai:digital.csic.es:10261/2140612022-04-05T12:05:37Zcom_10261_11773com_10261_1col_10261_11774
DIGITAL.CSIC
author
Regidor, Ignacio
author
Santos-García, Diego
author
Catalán, M. J.
author
Puente, Víctor
author
Valldeoriola, Francesc
author
Grandas, Francisco
author
Mir, Pablo
author
Parra, Juan Carlos
author
Arbelo, José Matias
2020-06-10T12:33:02Z
2020-06-10T12:33:02Z
2019-02-05
Journal of Parkinsons Disease 9(1): 173-182 (2019)
http://hdl.handle.net/10261/214061
10.3233/JPD-181324
[Background] Levodopa-carbidopa intestinal gel (LCIG) is effective in the treatment of advanced Parkinson’s disease (PD). However, the patients’ profile that might benefit from treatment with LCIG has not been characterized.
[Objective]This retrospective study explored the influence of disease duration (DD) on the effectiveness of LCIG and identified factors associated with treatment discontinuation in a cohort of advanced PD patients.
[Methods] Patients initiating LCIG therapy between Jan-2006 and Dec-2011 in 18 Spanish centers were included. Effectiveness in treating motor symptoms (MSs), non-motor symptoms (NMSs), and adverse events (AEs) occurrence was compared in DD≥10 or <10 years and LCIG continuation/discontinuation groups. Factors associated with LCIG discontinuation were evaluated using univariate and multivariate analyses.
[Results] Overall, 177 PD patients were included (52.5% male; mean age 70.6±8.4 years; mean LCIG duration 35.6±18.6 months). Patients with DD≥10 years (n = 125) experienced less reduction in “off” time (–29%) than those with DD <10 years (–38%; n = 51; p = 0.021), and reported more severe AEs (32.8% vs. 17.6%; p = 0.043). DD did not significantly influence changes in NMSs or discontinuation rates. Fifty-four patients discontinued LCIG therapy, factors associated with discontinuation were higher percentages of waking day in the “off” state (OR, 1.028; 95% CI, 1.002–1.055; p = 0.0360) and in the “on” state with troublesome dyskinesia (OR, 1.032; 95% CI, 1.002–1.064; p = 0.0376) at baseline.
[Conclusions] Advanced PD patients with DD <10 years might benefit more from treatment with LCIG than patients with a longer DD. Although MSs severity at baseline was statistically associated with LCIG discontinuation, the probability was very low with little clinical significance.
closedAccess
Parkinson’s disease
Levodopa-carbidopa intestinal gel
Non-motor symptoms
Global clinical impression
Impact of Disease Duration in Effectiveness of Treatment with Levodopa-Carbidopa Intestinal Gel and Factors Leading to Discontinuation
artículo
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
URL
https://digital.csic.es/bitstream/10261/214061/1/accesoRestringido.pdf
File
MD5
42637ae8545636bc41605c1740a9a84e
15753
application/pdf
accesoRestringido.pdf