Levodopa-carbidopa intestinal gel decreases dyskinesia in patients with Parkinson's Disease: Study

Spain: A new research discovered that levodopa-carbidopa intestinal gel (LCIG) dramatically decreased dyskinesia when compared to oral optimal medical therapy (OMT). LCIG showed success in the treatment of bothersome dyskinesia in individuals with advanced Parkinson's disease, as well as advantages in motor and non-motor symptoms and Quality of Life (QoL).

The study was conducted by Eric Freire-Alvarez and team, findings of which were published in the journal Movement Disorders. 

There is a scarcity of data on the efficacy of LCIG for dyskinesia. As a result, the purpose of this study was to compare the efficacy of LCIG with OMT for dyskinesia in patients with advanced Parkinson's disease (PD) using the Unified Dyskinesia Rating Scale (UDysRS).

In this phase 3b, open-label, multicenter, 12-week interventional research randomized 63 LCIG-naive patients with advanced Parkinson's disease (UDysRS 30) to LCIG (N = 30) or OMT (N = 33). The UDysRS was used to measure the impact of dyskinesia from baseline to week 12. Quality of life (QoL) and motor and non-motor symptoms associated with Parkinson's disease (PD) were also evaluated.

The key finding of this study are:

1. After 12 weeks, dyskinesias assessed by UDysRS were considerably lower in the LCIG group (n = 24; 17.37 2.79) compared to the OMT group (n = 26; 2.33 2.56) (15.05 3.20).

2. At week 12, LCIG outperformed OMT in "On" time without bothersome dyskinesia, QoL, general impression of change, activities of daily living, and Unified Parkinson's Disease Rating Scale (UPDRS) Part III.

3. In 27 (44.3%) of the patients, treatment-emergent adverse events were recorded (LCIG, 18 [64.3% ]; OMT, 9 [27.3% ]). Two (7.1%) of the LCIG-treated individuals experienced serious adverse events.

In conclusion, the findings support some of the effectiveness findings for LCIG and demonstrate benefit in comparison to dyskinesia as measured directly with dyskinesia-specific metrics. The findings also provide information on the potential side effects of this treatment.

Reference:

Freire‐Alvarez, E., Kurča, E., Lopez Manzanares, L., Pekkonen, E., Spanaki, C., Vanni, P., Liu, Y., Sánchez‐Soliño, O., & Barbato, L. M. (2021). Levodopa‐Carbidopa Intestinal Gel Reduces Dyskinesia in Parkinson's Disease in a Randomized Trial. In Movement Disorders (Vol. 36, Issue 11, pp. 2615–2623). Wiley. https://doi.org/10.1002/mds.28703