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Journal of Neural Transmission

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22.02.2017 | Neurology and Preclinical Neurological Studies - Original Article

Levodopa/carbidopa intestinal gel (LCIG) infusion as mono- or combination therapy

verfasst von: Carsten Buhmann, R. Hilker, P. Lingor, C. Schrader, J. Schwarz, M. Wolz, H. Reichmann

Erschienen in: Journal of Neural Transmission | Ausgabe 8/2017

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Abstract

Levodopa/carbidopa intestinal gel (LCIG) infusion is an effective escalating therapy in patients with Parkinson disease (PD) suffering from motor fluctuations and dyskinesia. Levodopa/carbidopa given continuously as infusion provides an optimized application of the most effective and best tolerable antiparkinsonian drug. It has been proven to have a superior motor effect compared with oral levodopa and to improve also non-motor symptoms. However, invasiveness, discomfort resulting from carrying an external device, and side effects associated with the way of administration limit its application in PD patients. At present, there are no guidelines that delineate to which patients LCIG should be offered as monotherapy, in combination with oral and/or transdermal medication, or as additional therapy to deep brain stimulation (DBS). Based on clinical studies, we propose an expert consensus for neurologists addressing the question when LCIG therapy should be recommended and in which cases LCIG infusion is suggested in combination with other antiparkinsonian drugs and/or DBS. We describe how LCIG should be initiated and what we consider necessary for clinical follow-up. We suggest an algorithm facilitating decision-making with respect to the currently available invasive PD therapies, namely infusion with subcutaneous apomorphine, LCIG, and DBS.

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Titel: Levodopa/carbidopa intestinal gel (LCIG) infusion as mono- or combination therapy
verfasst von: Carsten Buhmann
R. Hilker
P. Lingor
C. Schrader
J. Schwarz
M. Wolz
H. Reichmann
Publikationsdatum: 22.02.2017
Verlag: Springer Vienna
Erschienen in: Journal of Neural Transmission / Ausgabe 8/2017
Print ISSN: 0300-9564
Elektronische ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-017-1698-7

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Levodopa/carbidopa intestinal gel (LCIG) infusion as mono- or combination therapy

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