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

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.

journal_name

Parkinsonism Relat Disord

journal_title

Parkinsonism & related disorders

authors

Sensi M,Cossu G,Mancini F,Pilleri M,Zibetti M,Modugno N,Quatrale R,Tamma F,Antonini A,ITALIAN LEVODOPA CARBIDOPA INTESTINAL GEL WORKING GROUP.

doi

10.1016/j.parkreldis.2017.02.020

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

90-92

eissn

1353-8020

issn

1873-5126

pii

S1353-8020(17)30070-6

journal_volume

pub_type

杂志文章,多中心研究

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