Objectives To report the results of a national survey aimed at quantifying the current level of diffusion of Levodopa/carbidopa intestinal gel (LCIG) in Italy. Methods Sixty Parkinson's Disease (PD) specialists in Italy were invited to complete a survey covering issues on clinical and practical aspects of LCIG therapy. Results Clinical features of 905 patients were collected retrospectively. The majority of centres reported the use of a multidisciplinary team, biochemistry testing, neurophysiological and neuropsychological tests before and after treatment, in addition to caregivers’ training and patient's follow as outpatients. Most centres (60%) used internal guidelines for patient selection. The overall rate of adverse events was 55.1%. Weight loss, chronic polyneuropathy and stoma infection were the most frequently reported. 40% of centres used replacement therapy with Vitamin B12 and Folic acid from the start of LCIG and continued this for the duration of treatment. The rate of discontinuation was of 25.7% overall, with 9.5% of cases occurring in the first year. The main causes of withdrawal were device-related complications, disease progression (comorbidity, severe dementia) and caregiver and/or patient dissatisfaction. Conclusions In Italy LCIG infusion is managed in a uniform manner at a clinical, practical and organizational level even though the selection criteria are not standardized through the country. The high percentage of patients remaining on treatment in the short- and long-term follow-up confirms effectiveness of treatment, careful follow-up, and appropriate patient and caregivers training.

Which patients discontinue? Issues on Levodopa/carbidopa intestinal gel treatment: Italian multicentre survey of 905 patients with long-term follow-up

Zibetti M.;Comi C.;Dematteis F.;Torre E.;
2017-01-01

Abstract

Objectives To report the results of a national survey aimed at quantifying the current level of diffusion of Levodopa/carbidopa intestinal gel (LCIG) in Italy. Methods Sixty Parkinson's Disease (PD) specialists in Italy were invited to complete a survey covering issues on clinical and practical aspects of LCIG therapy. Results Clinical features of 905 patients were collected retrospectively. The majority of centres reported the use of a multidisciplinary team, biochemistry testing, neurophysiological and neuropsychological tests before and after treatment, in addition to caregivers’ training and patient's follow as outpatients. Most centres (60%) used internal guidelines for patient selection. The overall rate of adverse events was 55.1%. Weight loss, chronic polyneuropathy and stoma infection were the most frequently reported. 40% of centres used replacement therapy with Vitamin B12 and Folic acid from the start of LCIG and continued this for the duration of treatment. The rate of discontinuation was of 25.7% overall, with 9.5% of cases occurring in the first year. The main causes of withdrawal were device-related complications, disease progression (comorbidity, severe dementia) and caregiver and/or patient dissatisfaction. Conclusions In Italy LCIG infusion is managed in a uniform manner at a clinical, practical and organizational level even though the selection criteria are not standardized through the country. The high percentage of patients remaining on treatment in the short- and long-term follow-up confirms effectiveness of treatment, careful follow-up, and appropriate patient and caregivers training.
2017
38
90
92
Levodopa-carbidopa intestinal gel infusion; Neuropathy; Parkinson's disease; Withdrawal; Antiparkinson Agents; Carbidopa; Disease Progression; Drug Combinations; Female; Gels; Health Surveys; Humans; Intestines; Italy; Levodopa; Longitudinal Studies; Male; Parkinson Disease; Retrospective Studies; Substance Withdrawal Syndrome
Sensi M.; Cossu G.; Mancini F.; Pilleri M.; Zibetti M.; Modugno N.; Quatrale R.; Tamma F.; Antonini A.; Aguggia M.; Amboni M.; Arca R.; Bartolomei L.; Bonetto N.; Calandra-Buonaura G.; Bove F.; Calandrella D.; Canesi M.; Cannas A.; Capecci M.; Caputo E.; Ceravolo M.G.; Ceravolo R.; Cerrone G.; Coletti Moja M.; Comi C.; Cortelli P.; D'Antonio P.; Dematteis F.; Di Lazzaro V.; Eleopra R.; Fabbrini G.; Fichera M.; Grassi E.; Guido M.; Gusmaroli G.; Latorre A.; Malaguti M.C.; Marano M.; Marano P.; Marconi R.; Mazzucchi S.; Meco G.; Minafra B.; Morgante F.; Pacchetti C.; Pierantozzi M.; Pontieri F.E.; Riboldazzi G.; Ricchi V.; Ricchieri G.; Rinaldo S.; Rispoli V.; Rossi S.; Rubino A.; Russo A.; Saddi M.V.; Stefani A.; Simoni S.; Solla P.; Tambasco N.; Tamburin S.; Tessitore A.; Torre E.; Ulivelli M.; Vita M.G.; Volonte M.A.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1837021
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