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.

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

CERAVOLO, ROBERTO;MAZZUCCHI, SONIA;
2017-01-01

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.
2017
Sensi, Mariachiara; Cossu, Giovanni; Mancini, Francesca; Pilleri, Manuela; Zibetti, Maurizio; Modugno, Nicola; Quatrale, Rocco; Tamma, Filippo; Antonini, Angelo; Aguggia, Marco; Amboni, Marianna; Arca, Roberta; Bartolomei, Luigi; Bonetto, Nicola; Calandra Buonaura, Giovanna; Bove, Francesco; Calandrella, Daniela; Canesi, Margherita; Cannas, Antonino; Capecci, Marianna; Caputo, Elena; Ceravolo, Maria Gabriella; Ceravolo, Roberto; Cerrone, Gloria; Coletti Moja, Mario; Comi, Cristoforo; Cortelli, Pietro; D'Antonio, Paola; Dematteis, Francesca; Di Lazzaro, Vincenzo; Eleopra, Roberto; Fabbrini, Giovanni; Fichera, Mario; Grassi, Enrico; Guido, Marco; Gusmaroli, Graziano; Latorre, Anna; Malaguti, Maria Chiara; Marano, Massimo; Marano, Pietro; Marconi, Roberto; Mazzucchi, Sonia; Meco, Giuseppe; Minafra, Brigida; Morgante, Francesca; Pacchetti, Claudio; Pierantozzi, Mariangela; Pontieri, Francesco E.; Riboldazzi, Giulio; Ricchi, Valeria; Ricchieri, Gianluigi; Rinaldo, Sara; Rispoli, Vittorio; Rossi, Simone; Rubino, Alfonso; Russo, Antonio; Saddi, Maria Valeria; Stefani, Alessandro; Simoni, Simone; Solla, Paolo; Tambasco, Nicola; Tamburin, Stefano; Tessitore, Alessandro; Torre, Elena; Ulivelli, Monica; Vita, Maria Gabriella; Volonté, Maria Antonietta
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/866025
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