The first randomized, placebo-controlled trial of intrajejunal levodopa provides support for the benefits of continuous dopaminergic drug delivery. Motor fluctuations in patients with advanced Parkinson disease were markedly improved. In clinical practice, the symptomatic benefits of this treatment need to be weighed carefully against its adverse effect profile.
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References
Olanow, C. W. et al. Continuous intrajejunal infusion of levodopa–carbidopa intestinal gel for patients with advanced Parkinson's disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol. 13 141–149 (2014).
Olanow, C. W., Obeso, J. A. & Stocchi, F. Continuous dopamine-receptor treatment of Parkinson's disease: scientific rationale and clinical implications. Lancet Neurol. 5, 677–687 (2006).
Nutt, J. G. Pharmacokinetics and pharmacodynamics of levodopa. Mov. Disord. 23 (Suppl. 3), S580–S584 (2008).
Fox, S. H. et al. The Movement Disorder Society evidence-based medicine review update: treatments for the motor symptoms of Parkinson's disease. Mov. Disord. 26 (Suppl. 3), S2–S41 (2011).
Deuschl, G. & Agid, Y. Subthalamic neurostimulation for Parkinson's disease with early fluctuations: balancing the risks and benefits. Lancet Neurol. 12, 1025–1034 (2013).
Wirth, R. et al. Complications and mortality after percutaneous endoscopic gastrostomy in geriatrics: a prospective multicenter observational trial. J. Am. Med. Dir. Assoc. 13, 228–233 (2012).
Richter-Schrag, H. J. et al. Risk factors and complications following percutaneous endoscopic gastrostomy: a case series of 1041 patients. Can. J. Gastroenterol. 25, 201–206 (2011).
Toth, C. et al. Levodopa, methylmalonic acid, and neuropathy in idiopathic Parkinson disease. Ann. Neurol. 69, 28–36 (2010).
Fernandez, H. H. et al. Levodopa–carbidopa intestinal gel in advanced Parkinson's disease open-label study: interim results. Parkinsonism Relat. Disord. 19, 339–345 (2013).
Müller, T. et al. Peripheral neuropathy in Parkinson's disease: levodopa exposure and implications for duodenal delivery. Parkinsonism Relat. Disord. 19, 501–507 (2013).
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R.K. has received research funding from Novartis, Bial and Schering-Plough. Both authors have received consultancy fees and lecture fees in relation to clinical drug development programmes for Parkinson disease from Abbvie and Novartis. In addition, R.K. has received fees for consultancy and lectures from AOP Orphan, Biogen, Britannia, Ever Pharma, Lundbeck, Stada and UCB, and W.P. has received fees for consultancy and lectures from Astra Zeneca, Boehringer-Ingelheim, GlaxoSmithKline, Merck Serono, Merz Pharmaceuticals, Orion Pharma, Teva and UCB.
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Katzenschlager, R., Poewe, W. Intestinal levodopa infusion in PD—the first randomized trial. Nat Rev Neurol 10, 128–129 (2014). https://doi.org/10.1038/nrneurol.2014.26
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DOI: https://doi.org/10.1038/nrneurol.2014.26