Is levodopa-carbidopa intestinal gel an effective treatment for patients with Parkinson’s disease?

This study investigated the effectiveness and safety of levodopa-carbidopa intestinal gel (LCIG; Duodopa) in the treatment of patients with Parkinson's disease. Researchers suggested that LCIG alone is a safe and effective option as a treatment for these patients.

Parkinson disease affects brain cells. These cells control different body movement and function. Patients with Parkinson's disease (PD) lose the abilities controlled by these cells. This causes symptoms such as muscle weakness or tremors. The standard treatment for these patients is levodopa-based therapy. However, long-term levodopa is associated with negative side effects such as off-times dyskinesia (abnormal body movements) impacting quality of life. Off-times consist in the period between levodopa doses when the PD symptoms come back, sometimes worse.   

Prior studies showed that LCIG reduces the negative effects of long-term levodopa. This may be due to the continuous mode of delivery which results in less variation of the drug in the bloodstream. However, the effectiveness of LCIG alone or combined with another agent is not known.

This study included 208 patients with advanced PD. These patients were assigned to receive LCIG alone (group 1; 80), LCIG with oral levodopa (group 2; 47) or LCIG with any other PD therapy (group 3; 81). Patients were followed-up for 24 months.

Patients in group 1 showed improvements in daily activities until month 18. Until month 24, they showed improvements in quality of life, movement, and non-movement symptoms, off-times, and dyskinesia. More patients in group 2 and 3 showed negative side effects including dyskinesia when compared with group 1. One case of severe neuropathy (numbness and pain in the hands and/or feet) led to the end of treatment with levodopa.

This study concluded that LCIG alone is a safe treatment option for patients advanced Parkinson's disease.

This study was based on medical records. Some information might have been incomplete. This might affect the results.