Intrajejunal levodopa versus conventional therapy in parkinson disease: Motor and nonmotor effects

Prashanth Reddy, Pablo Martinez-Martin, Alexandra Rizos, Anne Martin, Guy C. Faye, Ian Forgacs, Per Odin, Angelo Antonini, K. Ray Chaudhuri

Research output: Contribution to journalArticle

Abstract

Seventeen patients with advanced Parkinson disease (PD) were treated with intrajejunal L-dopa infusion (IJL) and compared with a matched group of 9 patients (termed comparator [C]) not given IJL because of funding restriction by primary care trusts (PCTs) in the UK, although considered to be clinically eligible for IJL. Assessments were baseline and follow-up (6 months) with Hoehn and Yahr staging, unified PD rating scale (UPDRS-III and UPDRS-IV), Parkinson disease questionnaire (PDQ-8, quality of life [QoL]) and nonmotor symptom scale (NMSS).Baseline characteristics were comparable between the groups. The IJL-treated group showed highly significant improvements in UPDRS-III (P = 0.005), UPDRS-IV (P = 0.0004), total NMSS score (P = 0.004), and QoL (P = 0.01), whereas the C group showed no change in these parameters. A large effect size of IJL was seen in treated patients for UPDRS-III (1.13), UPDRS-IV (1.52), NMSS score (0.82), and QoL (1.12), whereas continuing conventional treatment registered no effect in C.This study confirms the robust effect of IJL on motor and, in particular, nonmotor symptoms and QoL in advanced PD as described in open-label studies but additionally points to the need for such treatment in those denied this therapy because of centrally dictated funding policies leading to inequalities in health care.

Original languageEnglish
Pages (from-to)205-207
Number of pages3
JournalClinical Neuropharmacology
Volume35
Issue number5
DOIs
Publication statusPublished - Sep 2012

Keywords

  • intrajejunal L-dopa infusion
  • motor
  • nonmotor
  • Parkinson disease
  • quality of life

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Clinical Neurology

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    Reddy, P., Martinez-Martin, P., Rizos, A., Martin, A., Faye, G. C., Forgacs, I., Odin, P., Antonini, A., & Chaudhuri, K. R. (2012). Intrajejunal levodopa versus conventional therapy in parkinson disease: Motor and nonmotor effects. Clinical Neuropharmacology, 35(5), 205-207. https://doi.org/10.1097/WNF.0b013e3182613dea