Patient profile, indications, efficacy and safety of duodenal levodopa infusion in advanced Parkinson's disease
Identifieur interne : 002139 ( Main/Exploration ); précédent : 002138; suivant : 002140Patient profile, indications, efficacy and safety of duodenal levodopa infusion in advanced Parkinson's disease
Auteurs : David Devos [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-05-15.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Advanced stage, Aged, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Complication, Dementia (drug therapy), Dementia (etiology), Duodenum, Duodenum (physiology), Duodopa, Female, Gait Disorders, Neurologic (drug therapy), Gait Disorders, Neurologic (etiology), Hallucinations (drug therapy), Hallucinations (etiology), Human, Humans, Indication, Levodopa, Levodopa (administration & dosage), Levodopa (adverse effects), Male, Nervous system diseases, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson Disease (psychology), Parkinson disease, Parkinson's disease, Personal Autonomy, Quality of Life (psychology), Retrospective Studies, Safety, Treatment Outcome, continuous dopaminergic stimulation, duodenal infusion, levodopa‐related motor complications.
- MESH :
- chemical , administration & dosage : Levodopa.
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- chemical , therapeutic use : Antiparkinson Agents.
- complications : Parkinson Disease.
- drug therapy : Dementia, Gait Disorders, Neurologic, Hallucinations, Parkinson Disease.
- etiology : Dementia, Gait Disorders, Neurologic, Hallucinations.
- physiology : Duodenum.
- psychology : Parkinson Disease, Quality of Life.
- Aged, Female, Humans, Male, Personal Autonomy, Retrospective Studies, Treatment Outcome.
Abstract
The studies of duodenal infusion of a levodopa on small groups of parkinsonian patients have reported beneficial effects on motor complications. However, little is known about the patient profile and indications for duodenal levodopa infusion. The purpose of this study is to exhaustively investigate the clinical characteristics of the population and indication, efficacy and tolerability of duodenal levodopa infusion in natural care settings. Of the 102 patients treated with duodenal levodopa infusion since 2003, 91 were enrolled in a multicentre retrospective study. The mean age was 72.7 years, with average disease duration of 17 years. Patients were at advanced stage: 91% had gait disorders, 65% had visual hallucinations, and 50% were demented (MMSE: 23). Duodenal levodopa infusion was the last line of treatment for motor complications in 98% of the patients, due to failure of or contraindication for apomorphine pump and neurosurgical treatments. Long‐term treatment was observed by 73% of the population. Of these, >90% reported an improvement in motor fluctuations, quality of life, and autonomy. There were few severe adverse events. Technical problems were commonplace. Duodenal levodopa infusion seems to be an effective last‐line therapy for motor complications in Parkinson's disease. Hence, technical improvements and earlier introduction should be considered. © 2009 Movement Disorder Society.
Url:
- https://api.istex.fr/document/C5368A4642F9B7FA553ABBC164906B03A966A238/fulltext/pdf
- http://www.hal.inserm.fr/inserm-00410554
DOI: 10.1002/mds.22450
Affiliations:
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Le document en format XML
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<term>Antiparkinson Agents (therapeutic use)</term>
<term>Complication</term>
<term>Dementia (drug therapy)</term>
<term>Dementia (etiology)</term>
<term>Duodenum</term>
<term>Duodenum (physiology)</term>
<term>Duodopa</term>
<term>Female</term>
<term>Gait Disorders, Neurologic (drug therapy)</term>
<term>Gait Disorders, Neurologic (etiology)</term>
<term>Hallucinations (drug therapy)</term>
<term>Hallucinations (etiology)</term>
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<term>Indication</term>
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<term>Levodopa (administration & dosage)</term>
<term>Levodopa (adverse effects)</term>
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<term>Nervous system diseases</term>
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<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (psychology)</term>
<term>Parkinson disease</term>
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<term>Retrospective Studies</term>
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<term>Treatment Outcome</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Dementia</term>
<term>Gait Disorders, Neurologic</term>
<term>Hallucinations</term>
<term>Parkinson Disease</term>
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<term>Hallucinations</term>
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<term>Humans</term>
<term>Male</term>
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<term>Retrospective Studies</term>
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<term>Pathologie du système nerveux</term>
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<front><div type="abstract" xml:lang="en">The studies of duodenal infusion of a levodopa on small groups of parkinsonian patients have reported beneficial effects on motor complications. However, little is known about the patient profile and indications for duodenal levodopa infusion. The purpose of this study is to exhaustively investigate the clinical characteristics of the population and indication, efficacy and tolerability of duodenal levodopa infusion in natural care settings. Of the 102 patients treated with duodenal levodopa infusion since 2003, 91 were enrolled in a multicentre retrospective study. The mean age was 72.7 years, with average disease duration of 17 years. Patients were at advanced stage: 91% had gait disorders, 65% had visual hallucinations, and 50% were demented (MMSE: 23). Duodenal levodopa infusion was the last line of treatment for motor complications in 98% of the patients, due to failure of or contraindication for apomorphine pump and neurosurgical treatments. Long‐term treatment was observed by 73% of the population. Of these, >90% reported an improvement in motor fluctuations, quality of life, and autonomy. There were few severe adverse events. Technical problems were commonplace. Duodenal levodopa infusion seems to be an effective last‐line therapy for motor complications in Parkinson's disease. Hence, technical improvements and earlier introduction should be considered. © 2009 Movement Disorder Society.</div>
</front>
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