Can suitable candidates for levodopa/carbidopa intestinal gel therapy be identified using current evidence?
Catalán Alonso, Maria José (Hospital Clínico San Carlos (Madrid))
Antonini, Angelo (Istituto di Ricovero e Cura A Carattere Scientifico (IRCCS))
Calopa, Matilde (Hospital Universitari de Bellvitge)
Băjenaru, Ovidiu (University of Medicine and Pharmacy "Carol Davila" Bucharest - University Emergency Hospital, Department of Neurology, Bucharest, Romania)
Fàbregues-Boixar i Nebot, Oriol de (Hospital Universitari Vall d'Hebron)
Mínguez-Castellanos, Adolfo (Instituto de Investigación Sanitaria de Granada)
Odin, Per (Klinikum-Bremerhaven, Bremerhaven, Germany)
García Moreno, José Manuel (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Pedersen, Stephen W. (University of Copenhagen)
Pirtošek, Zvezdan (University Medical Centre, Ljubljana, Slovenia)
Kulisevsky, Jaime (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	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.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Parkinson's disease ; Intrajejunal infusion of levodopa/carbidopa intestinal gel ; Duodopa ; Motor symptoms ; Non-motor symptoms ; Quality of life
Publicat a:	eNeurologicalSci, Vol. 8 (july 2017) , p. 44-53, ISSN 2405-6502

DOI: 10.1016/j.ensci.2017.06.004
PMID: 29260038

10 p, 322.3 KB

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