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 longterm follow-up / Sensi, M.; Cossu, G.; Mancini, F.; Pilleri, M.; Zibetti, M.; Modugno, N.; Quatrale, R.; Tamma, F.; Antonini, A.; Aguggia, M.; Amboni, M.; Arca, R.; Bartolomei, L.; Bonetto, N.; Calandra-Buonaura, G.; Bove, F.; Calandrella, D.; Canesi, M.; Cannas, A.; Capecci, M.; Caputo, E.; Ceravolo, M. G.; Ceravolo, R.; Cerrone, G.; Coletti Moja, M.; Comi, C.; Cortelli, P.; D'Antonio, P.; Dematteis, F.; Di Lazzaro, V.; Eleopra, R.; Fabbrini, G.; Fichera, M.; Grassi, E.; Guido, M.; Gusmaroli, G.; Latorre, A.; Malaguti, M. C.; Marano, M.; Marano, P.; Marconi, R.; Mazzucchi, S.; Meco, G.; Minafra, B.; Morgante, F.; Pacchetti, C.; Pierantozzi, M.; Pontieri, F. E.; Riboldazzi, G.; Ricchi, V.; Ricchieri, G.; Rinaldo, S.; Rispoli, V.; Rossi, S.; Rubino, A.; Russo, A.; Saddi, M. V.; Stefani, A.; Simoni, S.; Solla, P.; Tambasco, N.; Tamburin, S.; Tessitore, A.; Torre, E.; Ulivelli, M.; Vita M., Gi; Volonté, M. A.; on behalf of, The; ITALIAN LEVODOPA CARBIDOPA INTESTINAL GEL WORKING, Group. - In: PARKINSONISM & RELATED DISORDERS. - ISSN 1353-8020. - 38:(2017), pp. 90-92. [10.1016/j.parkreldis.2017.02.020]

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

Modugno N.;Fabbrini G.;Meco G.;Pontieri F. E.;
2017

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
levodopa-carbidopa intestinal gel infusion; neuropathy; parkinson's disease; withdrawal
01 Pubblicazione su rivista::01a Articolo in rivista
Which patients discontinue? Issues on Levodopa/carbidopa intestinal gel treatment. Italian multicentre survey of 905 patients with longterm follow-up / Sensi, M.; Cossu, G.; Mancini, F.; Pilleri, M.; Zibetti, M.; Modugno, N.; Quatrale, R.; Tamma, F.; Antonini, A.; Aguggia, M.; Amboni, M.; Arca, R.; Bartolomei, L.; Bonetto, N.; Calandra-Buonaura, G.; Bove, F.; Calandrella, D.; Canesi, M.; Cannas, A.; Capecci, M.; Caputo, E.; Ceravolo, M. G.; Ceravolo, R.; Cerrone, G.; Coletti Moja, M.; Comi, C.; Cortelli, P.; D'Antonio, P.; Dematteis, F.; Di Lazzaro, V.; Eleopra, R.; Fabbrini, G.; Fichera, M.; Grassi, E.; Guido, M.; Gusmaroli, G.; Latorre, A.; Malaguti, M. C.; Marano, M.; Marano, P.; Marconi, R.; Mazzucchi, S.; Meco, G.; Minafra, B.; Morgante, F.; Pacchetti, C.; Pierantozzi, M.; Pontieri, F. E.; Riboldazzi, G.; Ricchi, V.; Ricchieri, G.; Rinaldo, S.; Rispoli, V.; Rossi, S.; Rubino, A.; Russo, A.; Saddi, M. V.; Stefani, A.; Simoni, S.; Solla, P.; Tambasco, N.; Tamburin, S.; Tessitore, A.; Torre, E.; Ulivelli, M.; Vita M., Gi; Volonté, M. A.; on behalf of, The; ITALIAN LEVODOPA CARBIDOPA INTESTINAL GEL WORKING, Group. - In: PARKINSONISM & RELATED DISORDERS. - ISSN 1353-8020. - 38:(2017), pp. 90-92. [10.1016/j.parkreldis.2017.02.020]
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