Is carbidopa-levodopa enteral suspension a good treatment for Parkinson’s disease?

This article studied whether carbidopa-levodopa enteral suspension (CLES; Duopa) treatment improves the quality of life of patients with Parkinson's disease (PD). The authors found that CLES improved both quality of life and the ability of patients to perform daily activities.

Parkinson's disease (PD) is a disorder in which part of the brain is damaged over the years. This leads to an involuntary shaking of particular parts of the body (tremor), slow movements, and stiff and inflexible muscles. 

The treatments available for PD are only able to relieve symptoms. A common treatment for PD is called levodopa or levodopa/carbidopa combinations. This drug is absorbed by the nerves and is transformed into dopamine, a molecule that controls movements. By increasing the amount of dopamine, problems related to movements are improved.

However, the positive effects of levodopa are not long-lasting. Sometimes the symptoms come back before the next dose even worse. This is called wearing-off or motor fluctuations. One way to solve this is to maintain constant levels of levodopa in the blood. CLES is a newer form of delivering the PD medications in gel form continually directly to the intestine through a pump placed through surgery. CLES has been shown to improve the symptoms of PD. However, previous studies had different methods and follow-up. Therefore, the durability of the CLES impact on PD symptoms is still not clear.

This study analyzed data from 26 different studies. Overall, 1556 patients with PD were analyzed. All patients were diagnosed with advanced PD and received CLES treatment. The authors analyzed the quality of life, the ability of patients to perform daily activities, and the movements of muscles.

Within 2 months of CLES treatment, all outcomes analyzed (quality of life, the ability of patients to perform daily activities, and the movements of muscles) were improved. Wearing-off symptoms were improved by an average of 3.48 hours per day after using CLES for 3 months. All these improvements were maintained after 24 months of treatment. 

This study showed that CLES improves the quality of life and symptoms of PD as well as the ability of patients to perform daily tasks.

This study was funded by AbbVie, the manufacturer of CLES. There was no direct comparison with regular levodopa/carbidopa.