An Observational Study of the Effect of Levodopa–Carbidopa Intestinal Gel on Activities of Daily Living and Quality of Life in Advanced Parkinson’s Disease Patients

Rejko Krüger, Paul Lingor, Triantafyllos Doskas, Johanna M.L. Henselmans, Erik H. Danielsen, Oriol de Fabregues, Alessandro Stefani, Sven Christian Sensken, Juan Carlos Parra, Koray Onuk, Ashley Yegin, Angelo Antonini

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Continuous delivery of levodopa–carbidopa intestinal gel (LCIG) by percutaneous endoscopic gastrojejunostomy (PEG-J) in advanced Parkinson’s disease (PD) patients reduces variability in plasma levels, providing better control of motor fluctuations (“on” and “off” states). The MONOTREAT study assessed the effect of LCIG on activities of daily living, motor and non-motor symptoms, and quality of life in advanced PD patients. Methods: This prospective, observational study included patients with advanced, levodopa-responsive PD with either 2–4 h of “off” time or 2 h of dyskinesia daily. Patients received LCIG via PEG-J for 16 h continuously. Effectiveness was assessed using Unified PD Rating Scale parts II and III, the Non-Motor Symptom Scale, and the PD Questionnaire-8. Results: The mean (SD) treatment duration was 275 (157) days. Patients experienced significant improvement from baseline in activities of daily living at final visit (p < 0.05) as well as at months 3 and 6 (p < 0.0001). Patients also experienced significant improvements from baseline in quality of life and non-motor symptoms at all time points (p < 0.001 for all). Specifically, patients manifested significant improvements in mean change from baseline at every study visit in five of nine non-motor symptom score domains: sleep/fatigue, mood/cognition, gastrointestinal tract, urinary, and miscellaneous. One-third of patients (32.8%) experienced an adverse event; 21.9% experienced a serious adverse event; 11.1% discontinued because of an adverse event. Conclusion: This study demonstrated significant and clinically relevant improvements in measures of activities of daily living, quality of life, and a specific subset of non-motor symptoms after treatment with LCIG. Funding: AbbVie Inc.

Original languageEnglish
Pages (from-to)1741-1752
Number of pages12
JournalAdvances in Therapy
Volume34
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

Keywords

  • Activities of daily living
  • Levodopa–carbidopa intestinal gel
  • Parkinson’s disease
  • Percutaneous endoscopic gastrojejunostomy
  • Quality of life

ASJC Scopus subject areas

  • Pharmacology (medical)

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