Levodopa-carbidopa intestinal gel reduces ‘off’ time in patients with advanced Parkinson’s disease

   A levodopa-carbidopa intestinal gel (LCIG) is more effective than standard oral levodopa-carbidopa in reducing “off” time in patients with advanced Parkinson’s disease. That’s according to results of the phase three randomized, double-blind clinical trial. “Off” time occurs when Parkinson’s symptoms like tremor, slowness, stiffness, and walking difficulty return as the beneficial effects of oral treatment wears off.

   The intestinal gel contains the two drugs that are commonly prescribed for Parkinson’s, and is infused through a portable pump connected to a tube implanted in the intestine, similar to a feeding tube. The improved efficacy devolved from the infusion of LCIG occurring levodopa-carbidopa continuously, thereby avoiding the fluctuating levels that occur with standard oral therapy.

   C. Warren Olanow, MD, Professor of Neurology and Neuroscience at the Mount Sinai School of Medicine in New York, was lead author of the study, a three-month, double-blind trial with 71 participants. According to him, the study found that the continuous LCIG reduced ‘off’ time by an average of nearly two extra hours per day and improved “on” time without troublesome movements by an average of two hours per day compared to people taking standard levodopa-carbidopa. Treatment with LCIG was also not associated with an increase in troublesome dyskinesia.