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CNS Drugs Oct 2016
Review
Topics: Antiparkinson Agents; Carbidopa; Drug Combinations; Gels; Intestines; Levodopa; Parkinson Disease
PubMed: 27541607
DOI: 10.1007/s40263-016-0378-8 -
Minerva Medica Dec 2019We have performed a systematic literature review to evaluate the current evidence of the pharmacokinetic (PK), efficacy and safety profile of oral melevodopa/carbidopa...
INTRODUCTION
We have performed a systematic literature review to evaluate the current evidence of the pharmacokinetic (PK), efficacy and safety profile of oral melevodopa/carbidopa fixed combination in the management of motor fluctuations in patients with Parkinson disease (PD).
EVIDENCE ACQUISITION
Search has been started from common libraries and was then restricted to articles of studies in humans with melevodopa/carbidopa as fixed combination. Abstracts of international congresses have been also explored. The search has led to the identification of one PK study and five efficacy/safety studies that included more 743 PD patients overall, 488 of which treated with melevodopa/carbidopa effervescent tablets (Sirio®, Chiesi Farmaceutici S.p.A., Parma, Italy).
EVIDENCE SYNTHESIS
Melevodopa/carbidopa has a more rapid absorption, less apparent drug accumulation, less inter-patient variability and more effective LD delivery after the early morning and early afternoon dose compared to standard LD. Although they differed in used dose regimens, duration of treatment and endpoints, the results of the efficacy/safety studies suggest that treatment with melevodopa/carbidopa may determine improvements in motor fluctuations compared to treatment with standard LD/CD formulations, with no increased risk of adverse effects or LD-induced dyskinesias.
CONCLUSIONS
Data from literature have shown that melevodopa/carbidopa in a highly soluble formulation as effervescent oral tablets is effective in improving control of motor complications in PD patients compared to conventional levodopa. Further research is needed to confirm this evidence in large controlled trials and to explore if melevodopa/carbidopa may have a potential role in the earlier phases of the disease or in special PD populations.
Topics: Antiparkinson Agents; Carbidopa; Drug Combinations; Humans; Levodopa; Parkinson Disease
PubMed: 31965781
DOI: 10.23736/S0026-4806.19.06330-4 -
Drug Design, Development and Therapy 2020Levodopa-carbidopa intestinal gel (LCIG) is a new type of administration that results in steadier levodopa plasma concentrations in advanced Parkinson's disease (PD)...
BACKGROUND
Levodopa-carbidopa intestinal gel (LCIG) is a new type of administration that results in steadier levodopa plasma concentrations in advanced Parkinson's disease (PD) patients and effectively reduces poor mobility and dyskinesia.
METHODS
Electronic databases were searched up to January 1, 2018. The inclusion criteria for this review were as follows: LCIG vs oral medication in advanced PD patients.
RESULTS
Five trials, with a total of 198 patients, met all the inclusion criteria. The quality score of these studies ranged from 3 to 5. Two clinical trials showed that compared with oral medication, LCIG had a better treatment effect on on-time with troublesome dyskinesia (TSD) ( = 0.02) and on-time without TSD ( < 0.00001) in advanced PD patients. In addition, four of the 5 studies showed that the LCIG may have better efficacy than oral medication for improving the scores of the UPDRS, and two studies found that LCIG demonstrated better efficacy for improving the PDQ-39 scores. The video recording results indicated a potential decline in both dyskinesia and the "off" state in LCIG-treated patients. The incidence of adverse events was not significantly different between the LCIG and oral medication groups.
CONCLUSION
Compared with oral treatment, LCIG exerts its effectiveness, mostly by reducing the time of on-time with TSD, increasing the time of on-time without TSD and scores of UPDRS and PDQ-39. It is suggesting that LCIG was likely to be a new type of administration used in clinical applications. However, due to methodological flaws, these findings should be viewed with caution, and more RCTs are needed in the field to complement our findings.
Topics: Administration, Oral; Antiparkinson Agents; Carbidopa; Drug Combinations; Gels; Humans; Levodopa; Parkinson Disease
PubMed: 32161444
DOI: 10.2147/DDDT.S229621 -
Neurologia I Neurochirurgia Polska 2023Polyneuropathy (PNP) is a known complication of levodopa-carbidopa intestinal gel (LCIG) therapy of advanced Parkinson's Disease (PD). The overall prevalence of PNP in...
Polyneuropathy (PNP) is a known complication of levodopa-carbidopa intestinal gel (LCIG) therapy of advanced Parkinson's Disease (PD). The overall prevalence of PNP in PD is estimated to be 42.1% (as shown in a review by Romagnolo et al. 2018), and the most common type is chronic axonal polyneuropathy. There is a group of acute/subacute onset demyelinating polyneuropathies, which is far less common, although it seems to be an important factor leading to the rapid discontinuation of LCIG treatment. In this systematic review, we present data on demyelinating polyneuropathy with acute/subacute onset; we identified nine papers including prospective assessments and case reports, with detailed information on 15 patients. In all patients, despite treatment with corticosteroids, intravenous immunoglobulins (IVIG) or plasma exchange (PE), the LCIG therapy was terminated. We also present a case of subacute demyelinating polyneuropathy with effective treatment and continuation of LCIG therapy.
Topics: Humans; Carbidopa; Levodopa; Parkinson Disease; Antiparkinson Agents; Prospective Studies; Polyneuropathies; Drug Combinations; Gels
PubMed: 36628506
DOI: 10.5603/PJNNS.a2023.0001