AAN: Intestinal Gel Improves 'Off' Time in Parkinson's

Levodopa-carbidopa gel offers significant improvements versus immediate release tablets

WEDNESDAY, April 18 (HealthDay News) -- For patients with Parkinson's disease with motor complications, use of a levodopa-carbidopa intestinal gel (LCIG) is associated with improvements in "off" time and in "on" time without troublesome dyskinesia (TD), compared with levodopa-carbidopa immediate release (IR) tablets, according to a study presented at the annual meeting of the American Academy of Neurology, held from April 21 to 28 in New Orleans.

C. Warren Olanow, M.D., from the Mount Sinai School of Medicine in New York City, and colleagues compared the efficacy, safety, and tolerability of continuous LCIG during waking hours with oral levodopa-carbidopa IR for patients with Parkinson's disease with motor complications. Patients were randomly allocated to receive LCIG infusion and placebo capsules (37 patients) or encapsulated levodopa-carbidopa IR tablets and placebo gel infusion (34 patients) for 12 weeks.

For the 66 patients who completed the trial, the researchers found that, compared with IR, treatment with LCIG significantly improved "off" time (mean difference, −1.91 hour; P = 0.0015) and "on" time without TD (mean difference, 1.86 hour; P = 0.0059). "On" time with TD did not change significantly. Adverse events were seen in 95 percent of the LCIG group and 100 percent of the IR group, and included complication of device insertion, abdominal pain, procedural pain, and nausea.

"LCIG produced clinically meaningful and statistically superior improvements in 'off' time over IR, without increasing dyskinesia," the authors write. "Adverse events were generally related to the placement of intrajejunal tube."

The study was supported by Abbott, which manufactures the LCIG used in the study.

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