Comprehensive assessment of levodopa-carbidopa intestinal gel for Turkish advanced Parkinson's disease patients.

BACKGROUND/AIMS: Levodopa Carbidopa Intestinal Gel (lCIG) is an effective treatment modality in the management of advanced Parkinson?s disease (PD) besides frequent adverse events and different rates of dropouts. Efficacy and safety data regarding Turkish patients on LCIG is very limited. This study is aimed to report the efficacy and adverse effect profile of LCIG in detail among advanced PD patients from a Turkish movement disorders center. MATERIALS AND METHODS: Totally 22 patients (50% male) who started receiving LCIG between December 2014-March 2020 were recruited. Efficacy of LCIG was assessed with Unified Parkinson?s Disease Rating Scale motor score (UPDRS III), Clinical Global Improvement (CGI) scale and Quality of Life scale (PDQ8). Improvements of gait disorders, and non-motor features were also questioned. Adverse events (AE) were collated in three topics: related to percutaneous endoscopic gastrojejunostomy (PEG-J), device related and LCIG infusion related. RESULTS: Mean age and pre-LCIG disease duration were 66.7 (8.8) and 13.3 (8.0) years. UPDRS-III scores and H-Y scale assessments were significantly improved. Better quality of life scores, clinical global improvements, and improvements in dysarthria, dysphagia and gait have been observed. None of our patients had drop out or deceased during a mean 17.5 (12.3) months period. Overall 20 (90.9%) patients experienced at least one AE. Twelve patients had any PEG-J related complications; three of them had acute abdomen. Eight (36.4%) patients had device-associated problems. Half of the patients required at least one additional endoscopic procedure and device replacement was done of 7. Mean body weight were decreased from 69.5 to 62.5 kg and seven patients had newly onset PNP at follow-up electromyography. Dyskinesia related to LCIG infusion was observed in 5 (22.7%) patients. There was no significant increase in hallucination among patients. CONCLUSION: LCIG is an efficient treatment modality in management of Turkish patients with advanced Parkinson?s disease. Although most of patients had at least one AE, none of them dropped out. Patient selection, patient compliance and collaborative management are important steps affecting the success of modality.