Long-term safety and effectiveness of levodopa-carbidopa intestinal gel infusion
Fàbregues-Boixar i Nebot, Oriol de (Hospital Universitari Vall d'Hebron)
Dot, Joan (Hospital Universitari Vall d'Hebron)
Abu-Suboh Abadia, Monder (Hospital Universitari Vall d'Hebron)
Hernández-Vara, Jorge (Hospital Universitari Vall d'Hebron)
Ferré Masó, Alex (Hospital Universitari Vall d'Hebron)
Romero, Odile (Hospital Universitari Vall d'Hebron)
Ibarria, Marta (Hospital Universitari Vall d'Hebron)
Seoane, José Luis (Hospital Universitari Vall d'Hebron)
Raguer, Nuria (Hospital Universitari Vall d'Hebron)
Puiggros, Carolina (Hospital Universitari Vall d'Hebron)
Gómez, Maria Rosa (Hospital Universitari Vall d'Hebron)
Quintana, Manuel (Hospital Universitari Vall d'Hebron)
Armengol, Josep Ramon (Hospital Universitari Vall d'Hebron)
Álvarez Sabín, José (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Fecha:	2017
Resumen:	Levodopa-carbidopa intestinal gel () infusion has demonstrated to improve motor fluctuations. The aim of this study is to assess the long-term safety and effectiveness of infusion in advanced Parkinson's disease () patients with motor fluctuations and its effect in nonmotor symptoms. Adverse events () and their management, clinical motor, and nonmotor aspects were assessed up to 10 years. Thirty-seven patients were treated with ; in three subsets of patients, specific batteries of tests were used to assess cognitive and behavior assessment for 6 months, quality of sleep for 6 months, and quality of life and caregiver burden for 1 year. There was a high number of , but manageable, most of mild and moderate severity. All patients experienced significant improvement in motor fluctuations with a reduction in mean daily off time of 4. 87 hr after 3 months (n = 37) to 6. 25 hr after 9 years (n = 2). Diskynesias remained stables in 28 patients (75. 7%) and improved in 5 patients (13. 5%). There was no neuropsychological deterioration, but an improvement in attentional functions, voluntary motor control, and semantic fluency. Quality of sleep did not worsen, and there was an improvement in the subjective parameters, although overnight polysomnography did not change. There was a significant sustained improvement of 37% in -Q39 after 3 months and to 1 year, and a significant reduction in caregiver burden of 10% after 3 months. infusion is a safe and efficacious treatment for the control of motor fluctuations, and for improvement or nonworsening of nonmotor aspects, long-term sustained, and feasible for use in routine care.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Levodopa-carbidopa intestinal gel infusion ; Motor fluctuations ; Nonmotor symptoms ; Parkinson ; Safety
Publicado en:	Brain and behavior, Vol. 7 (july 2017) , ISSN 2162-3279

DOI: 10.1002/brb3.758
PMID: 28828219

10 p, 533.4 KB

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