Adverse effects of levodopa/carbidopa intrajejunal gel treatment : a single-center long-term follow-up study

Rus, Tomaž (avtor), Premzl, Maša (avtor), Zupančič-Križnar, Nina (avtor), Gregorič Kramberger, Milica (avtor), Rajnar, Robert (avtor), Ocepek, Lidija (avtor), Pirtošek, Zvezdan (avtor), Trošt, Maja (avtor)

Objectives: Levodopa/carbidopa intrajejunal gel (LCIG) is an effective therapeutic strategy to overcome levodopa-induced motor complications in advanced Parkinson's disease (PD). However, it requires invasive percutaneous endoscopic gastrojejunostomy (PEG-J) and may be associated with serious adverse effects (AE). In this study, we aimed to evaluate long-term AEs related to LCIG treatment in a large homogenous cohort of advanced PD patients. Methods: One hundred three consecutive PD patients were regularly monitored for LCIG-related, PEG-J-related, and device-related AEs up to 14 years. Incidence of AEs was studied in time applying a time-to-event analysis and Cox proportional hazard model with age, disease duration, gender, and recurrent AE as covariates. Health-related quality of life (HRQoL) was estimated at each visit and compared to HRQoL before the LCIG treatment. Results: Among 296 AEs noted, 48.8% were LCIG-related, 32.4% PEG-J-related, and 19.6% device-related. While most of the studied AEs steadily accumulated throughout the follow-up period, 24.3% of the patients (95% CI 10.1%–36.3%) experienced PEG-J-related AE already within the first days after the PEG-J insertion. Cox model revealed that older patients had higher probability of psychosis, PEG-J- and device-related AEs (p < .05, p < .05, and p = .02) and suggested increased recurrence risk in those with early PEG-J and device-related AEs. Despite relatively high incidence of AEs, HRQoL significantly increased in the follow-up period (p < .0001). Conclusion: AEs related to LCIG treatment are common. Therefore, careful patient selection and monitoring throughout the treatment is recommended, especially in those with early side effects. Nevertheless, LCIG significantly improves HRQoL in advanced PD patients on a long term.

• Jezik: Angleški jezik
• Ključne besede: advanced Parkinson's disease, levodopa-carbidopa intestinal gel, percutaneous endoscopic gastrojejunostomy, adverse effects, health-related quality of life
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2022
• Št. strani: Str. 537-544
• Številčenje: Vol. 146, iss. 5
• PID: 20.500.12556/RUL-143424
• UDK: 616.8
• ISSN pri članku: 0001-6314
• DOI: 10.1111/ane.13675
• COBISS.SI-ID: 117250307
• Datum objave v RUL: 20.12.2022

Gradivo je del revije

• Naslov: Acta neurologica Scandinavica
• Skrajšan naslov: Acta neurol. Scand.
• Založnik: Wiley
• ISSN: 0001-6314
• COBISS.SI-ID: 3710474

Licence

• Licenca: CC BY-NC 4.0, Creative Commons Priznanje avtorstva-Nekomercialno 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by-nc/4.0/deed.sl
• Opis: Licenca Creative Commons, ki prepoveduje komercialno uporabo, vendar uporabniki ne rabijo upravljati materialnih avtorskih pravic na izpeljanih delih z enako licenco.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: nevrologija, napredovala Parkinsonova bolezen, levdopa-karbidopa gel, perkutana endoskopska gastrojujenostoma, kvaliteta življenja, stranski učinki