Motor and nonmotor symptoms in patients treated with 24-hour daily levodopa-carbidopa intestinal gel infusion: Analysis of the COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS)

Norbert Kovács*, József Szász, Lydia Vela-Desojo, Per Svenningsson, Samira Femia, Juan Carlos Parra, Olga Sanchez-Soliño, Lars Bergmann, Tanya Gurevich, Alfonso Fasano

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Patients with advanced Parkinson's disease (APD) commonly experience motor and nonmotor symptoms (NMS) associated with functional limitations and decreased quality of life. We compared motor and nonmotor outcomes in patients with APD receiving 24- versus 16-h levodopa-carbidopa intestinal gel (LCIG). Methods: Data from COSMOS, a large, real-world, retrospective and cross-sectional, observational study on LCIG and comedication in APD were obtained from medical records and a single patient visit for patients receiving 24- and 16-h LCIG infusion. Changes from baseline were evaluated for motor symptoms, NMS, and clinical characteristics. Safety was also assessed. Results: Data for 401 patients were included in this subanalysis. At the patient visit there were 35 patients on 24-h LCIG and 366 on 16-h LCIG. “Off” time and dyskinesia (duration and severity) were reduced in both groups. In both LCIG treatment groups, prevalence of most symptoms was reduced. There were significant differences in the change from baseline in severity and frequency of freezing of gait with 24-h LCIG versus 16-h LCIG (p = 0.011 and p = 0.038), severity of urinary symptoms (p = 0.006), and frequency of cognitive impairment (p = 0.014) with 24-h LCIG versus 16-h LCIG. Adverse events were similar for both treatment groups and considered tolerable. Conclusions: LCIG 24-h infusion may be a useful treatment option, when clinically justified, for select patients with APD. Clinical trial number: NCT03362879.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalParkinsonism and Related Disorders
Volume105
DOIs
StatePublished - Dec 2022

Funding

FundersFunder number
DSMB
KRKA
Parkinson's Foundation and Israel innovation authorities
Michael J. Fox Foundation for Parkinson's Research
Abbott Laboratories
Pfizer
GlaxoSmithKline
Novartis
Medtronic
Teva Pharmaceutical Industries
AbbVie
Chiesi Farmaceutici
Allergan
Boehringer Ingelheim
Boston Scientific Corporation
Sunovion
UCB
Sandoz
Sanofi Genzyme
University of Toronto
Shire
Pécsi Tudományegyetem
Ipsen
National Research, Development and Innovation Office

    Keywords

    • 24-Hour
    • Advanced PD
    • LCIG
    • Motor complications
    • Non-motor symptoms

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