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Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease

Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex disabling dyskine...

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Autores principales: Szász, József Attila, Constantin, Viorelia Adelina, Orbán-Kis, Károly, Bancu, Ligia Ariana, Ciorba, Marius, Mihály, István, Nagy, Előd Ernő, Szász, Róbert Máté, Kelemen, Krisztina, Simu, Mihaela Adriana, Szatmári, Szabolcs
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301838/
https://www.ncbi.nlm.nih.gov/pubmed/34206596
http://dx.doi.org/10.3390/brainsci11070826
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author Szász, József Attila
Constantin, Viorelia Adelina
Orbán-Kis, Károly
Bancu, Ligia Ariana
Ciorba, Marius
Mihály, István
Nagy, Előd Ernő
Szász, Róbert Máté
Kelemen, Krisztina
Simu, Mihaela Adriana
Szatmári, Szabolcs
author_facet Szász, József Attila
Constantin, Viorelia Adelina
Orbán-Kis, Károly
Bancu, Ligia Ariana
Ciorba, Marius
Mihály, István
Nagy, Előd Ernő
Szász, Róbert Máté
Kelemen, Krisztina
Simu, Mihaela Adriana
Szatmári, Szabolcs
author_sort Szász, József Attila
collection PubMed
description Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex disabling dyskinesias, including diphasic dyskinesia. Methods: In this retrospective study, we analyzed the characteristics of patients with APD who had at least 30 min of diphasic dyskinesia (DID) in 3 consecutive days, were considered responders and were treated with LCIG in our clinic. Patients were evaluated before and after PEG and at 6, 12 and 18 months, when the changes in the therapy were recorded, and they completed a 7-point Global Patient Impression of Improvement (PGI-I) scale. Results: Forty patients fulfilled the inclusion criteria—out of which, 34 performed all visits. There was a substantial difference between the calculated and real LCIG (1232 ± 337 mg vs. 1823 ± 728 mg). The motor fluctuations and most dyskinesias improved significantly after starting LCIG, but an increasing number of patients needed longer daily administrations of LCIG (24 instead of 16 h). Conclusions: Patients with APD with complex dyskinesias must be tested in dedicated hospitals, and they need a special therapeutic approach. The properly adapted LCIG treatment regarding the dose and time of administration completed with well-selected add-on medication should offer improvement for patients who want to or can only choose this DAT vs. others.
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spelling pubmed-83018382021-07-24 Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease Szász, József Attila Constantin, Viorelia Adelina Orbán-Kis, Károly Bancu, Ligia Ariana Ciorba, Marius Mihály, István Nagy, Előd Ernő Szász, Róbert Máté Kelemen, Krisztina Simu, Mihaela Adriana Szatmári, Szabolcs Brain Sci Article Background: In the advanced stages of Parkinson’s disease (APD), complex forms of dyskinesia may severely impair the patient’s quality of life. Objective: In the present study, we aimed to analyze the evolution under LCIG therapy of the most important motor fluctuations and complex disabling dyskinesias, including diphasic dyskinesia. Methods: In this retrospective study, we analyzed the characteristics of patients with APD who had at least 30 min of diphasic dyskinesia (DID) in 3 consecutive days, were considered responders and were treated with LCIG in our clinic. Patients were evaluated before and after PEG and at 6, 12 and 18 months, when the changes in the therapy were recorded, and they completed a 7-point Global Patient Impression of Improvement (PGI-I) scale. Results: Forty patients fulfilled the inclusion criteria—out of which, 34 performed all visits. There was a substantial difference between the calculated and real LCIG (1232 ± 337 mg vs. 1823 ± 728 mg). The motor fluctuations and most dyskinesias improved significantly after starting LCIG, but an increasing number of patients needed longer daily administrations of LCIG (24 instead of 16 h). Conclusions: Patients with APD with complex dyskinesias must be tested in dedicated hospitals, and they need a special therapeutic approach. The properly adapted LCIG treatment regarding the dose and time of administration completed with well-selected add-on medication should offer improvement for patients who want to or can only choose this DAT vs. others. MDPI 2021-06-22 /pmc/articles/PMC8301838/ /pubmed/34206596 http://dx.doi.org/10.3390/brainsci11070826 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szász, József Attila
Constantin, Viorelia Adelina
Orbán-Kis, Károly
Bancu, Ligia Ariana
Ciorba, Marius
Mihály, István
Nagy, Előd Ernő
Szász, Róbert Máté
Kelemen, Krisztina
Simu, Mihaela Adriana
Szatmári, Szabolcs
Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
title Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
title_full Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
title_fullStr Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
title_full_unstemmed Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
title_short Management Challenges of Severe, Complex Dyskinesia. Data from a Large Cohort of Patients Treated with Levodopa-Carbidopa Intestinal Gel for Advanced Parkinson’s Disease
title_sort management challenges of severe, complex dyskinesia. data from a large cohort of patients treated with levodopa-carbidopa intestinal gel for advanced parkinson’s disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301838/
https://www.ncbi.nlm.nih.gov/pubmed/34206596
http://dx.doi.org/10.3390/brainsci11070826
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