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The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review

BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is a new type of administration that results in steadier levodopa plasma concentrations in advanced Parkinson’s disease (PD) patients and effectively reduces poor mobility and dyskinesia. METHODS: Electronic databases were searched up to January 1...

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Autores principales: Zhang, Xing-Ru, Jiang, Zhi-Yu, Zhang, Zeng-Rui, Chen, Hui-Jun, Wu, Ke, He, Jin-Cai, Xie, Cheng-Long
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050037/
https://www.ncbi.nlm.nih.gov/pubmed/32161444
http://dx.doi.org/10.2147/DDDT.S229621
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author Zhang, Xing-Ru
Jiang, Zhi-Yu
Zhang, Zeng-Rui
Chen, Hui-Jun
Wu, Ke
He, Jin-Cai
Xie, Cheng-Long
author_facet Zhang, Xing-Ru
Jiang, Zhi-Yu
Zhang, Zeng-Rui
Chen, Hui-Jun
Wu, Ke
He, Jin-Cai
Xie, Cheng-Long
author_sort Zhang, Xing-Ru
collection PubMed
description BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is a new type of administration that results in steadier levodopa plasma concentrations in advanced Parkinson’s disease (PD) patients and effectively reduces poor mobility and dyskinesia. METHODS: Electronic databases were searched up to January 1, 2018. The inclusion criteria for this review were as follows: LCIG vs oral medication in advanced PD patients. RESULTS: Five trials, with a total of 198 patients, met all the inclusion criteria. The quality score of these studies ranged from 3 to 5. Two clinical trials showed that compared with oral medication, LCIG had a better treatment effect on on-time with troublesome dyskinesia (TSD) (p = 0.02) and on-time without TSD (p < 0.00001) in advanced PD patients. In addition, four of the 5 studies showed that the LCIG may have better efficacy than oral medication for improving the scores of the UPDRS, and two studies found that LCIG demonstrated better efficacy for improving the PDQ-39 scores. The video recording results indicated a potential decline in both dyskinesia and the “off” state in LCIG-treated patients. The incidence of adverse events was not significantly different between the LCIG and oral medication groups. CONCLUSION: Compared with oral treatment, LCIG exerts its effectiveness, mostly by reducing the time of on-time with TSD, increasing the time of on-time without TSD and scores of UPDRS and PDQ-39. It is suggesting that LCIG was likely to be a new type of administration used in clinical applications. However, due to methodological flaws, these findings should be viewed with caution, and more RCTs are needed in the field to complement our findings.
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spelling pubmed-70500372020-03-11 The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review Zhang, Xing-Ru Jiang, Zhi-Yu Zhang, Zeng-Rui Chen, Hui-Jun Wu, Ke He, Jin-Cai Xie, Cheng-Long Drug Des Devel Ther Review BACKGROUND: Levodopa-carbidopa intestinal gel (LCIG) is a new type of administration that results in steadier levodopa plasma concentrations in advanced Parkinson’s disease (PD) patients and effectively reduces poor mobility and dyskinesia. METHODS: Electronic databases were searched up to January 1, 2018. The inclusion criteria for this review were as follows: LCIG vs oral medication in advanced PD patients. RESULTS: Five trials, with a total of 198 patients, met all the inclusion criteria. The quality score of these studies ranged from 3 to 5. Two clinical trials showed that compared with oral medication, LCIG had a better treatment effect on on-time with troublesome dyskinesia (TSD) (p = 0.02) and on-time without TSD (p < 0.00001) in advanced PD patients. In addition, four of the 5 studies showed that the LCIG may have better efficacy than oral medication for improving the scores of the UPDRS, and two studies found that LCIG demonstrated better efficacy for improving the PDQ-39 scores. The video recording results indicated a potential decline in both dyskinesia and the “off” state in LCIG-treated patients. The incidence of adverse events was not significantly different between the LCIG and oral medication groups. CONCLUSION: Compared with oral treatment, LCIG exerts its effectiveness, mostly by reducing the time of on-time with TSD, increasing the time of on-time without TSD and scores of UPDRS and PDQ-39. It is suggesting that LCIG was likely to be a new type of administration used in clinical applications. However, due to methodological flaws, these findings should be viewed with caution, and more RCTs are needed in the field to complement our findings. Dove 2020-02-26 /pmc/articles/PMC7050037/ /pubmed/32161444 http://dx.doi.org/10.2147/DDDT.S229621 Text en © 2020 Zhang et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Zhang, Xing-Ru
Jiang, Zhi-Yu
Zhang, Zeng-Rui
Chen, Hui-Jun
Wu, Ke
He, Jin-Cai
Xie, Cheng-Long
The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review
title The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review
title_full The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review
title_fullStr The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review
title_full_unstemmed The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review
title_short The Advantages of Levodopa-Carbidopa Intestinal Gel for Patients with Advanced Parkinson’s Disease: A Systematic Review
title_sort advantages of levodopa-carbidopa intestinal gel for patients with advanced parkinson’s disease: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050037/
https://www.ncbi.nlm.nih.gov/pubmed/32161444
http://dx.doi.org/10.2147/DDDT.S229621
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