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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

2017; Elsevier BV; Volume: 38; Linguagem: Inglês

10.1016/j.parkreldis.2017.02.020

1873-5126

Mariachiara Sensi, Giovanni Cossu, Francesca Mancini, Manuela Pilleri, Maurizio Zibetti, Nicola Modugno, R. Quatrale, Filippo Tamma, Angelo Antonini, Marco Aguggia, Marianna Amboni, Roberta Arca, Luigi Bartolomei, Nicola Bonetto, Giovanna Calandra‐Buonaura, Francesco Bove, Daniela Calandrella, Margherita Canesi, Antonino Cannas, Marianna Capecci, E. Caputo, Maria Gabriella Ceravolo, Roberto Ceravolo, Gloria Edith Cerrone, Mario Coletti Moja, Cristoforo Comi, Pietro Cortelli, Paola D’Antonio, Francesca Dematteis, Vincenzo Di Lazzaro, Roberto Eleopra, Giovanni Fabbrini, Mario Fichera, Enrico Grassi, Marco Guido, Graziano Gusmaroli, Anna Latorre, Maria Chiara Malaguti, Massimo Marano, Pietro Marano, Roberto Marconi, Sonia Mazzucchi, G. Meco, Brigida Minafra, Francesca Morgante, Claudio Pacchetti, Mariangela Pierantozzi, Francesco E. Pontieri, Giulio Riboldazzi, Valeria Ricchi, Gianluigi Ricchieri, Sara Rinaldo, Vittorio Rispoli, Símone Rossi, Alfonso Rubino, Antonio Russo, Maria Valeria Saddi, Alessandro Stefani, Simone Simoni, Paolo Solla, Nicola Tambasco, Stefano Tamburin, Alessandro Tessitore, Elena S. Torre, Monica Ulivelli, Maria Gabriella Vita, Maria Antonietta Volonté,

Botulinum Toxin and Related Neurological Disorders

To report the results of a national survey aimed at quantifying the current level of diffusion of Levodopa/carbidopa intestinal gel (LCIG) in Italy.Sixty Parkinson's Disease (PD) specialists in Italy were invited to complete a survey covering issues on clinical and practical aspects of LCIG therapy.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.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.