Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
Eur J Neurol. 2012 Aug;19(8):1079-85. doi: 10.1111/j.1468-1331.2012.03679.x. Epub 2012 Feb 23.
Infusion of levodopa/carbidopa intestinal gel (Duodopa ; Abbott) was introduced in Sweden in 1991 as an experimental treatment in advanced Parkinson's disease and obtained EU approval in 2004. There is compelling evidence for short-term use of this treatment; however, long-term data are scarce.
A retrospective review of medical records was performed. The primary objective was to assess the duration of treatment for all Swedish patients starting long-term levodopa/carbidopa gel therapy between January 1991 and June 2008. Secondary aims were to study demographics, treatment with anti-Parkinson's disease drugs and other concomitant medications, and reasons for discontinuation of levodopa/carbidopa gel.
Of 150 identified patients, 135 were included in the study. On average, patients were 49 years at diagnosis of Parkinson's disease and 63 years when infusion therapy was initiated. The median treatment time on infusion was 3.4 years (range, 0-16 years). The restricted mean treatment time was nearly 8 years; 81 patients were still on treatment at the end of the study. Levodopa was used as monotherapy in a majority of patients. Dosage of the drug was stable over time. Thirty-one patients discontinued infusion prior to the cutoff date and 23 patients died. Device-related problems were the most common reason for discontinuation. Patients were more likely to discontinue infusion therapy before 2000. The year of infusion initiation was significantly earlier in the dropout group compared with a matched group of continuing patients.
Levodopa/carbidopa intestinal gel infusion is a long-term treatment alternative in patients with advanced Parkinson's disease.
左旋多巴/卡比多巴肠凝胶（Duodopa；雅培）于 1991 年在瑞典作为晚期帕金森病的实验性治疗方法引入，2004 年获得欧盟批准。这种治疗方法的短期应用有充分的证据支持；然而，长期数据却很少。
对病历进行回顾性审查。主要目的是评估所有在 1991 年 1 月至 2008 年 6 月期间开始长期使用左旋多巴/卡比多巴凝胶治疗的瑞典患者的治疗持续时间。次要目的是研究人口统计学、抗帕金森病药物和其他伴随药物的治疗情况以及停止使用左旋多巴/卡比多巴凝胶的原因。
在确定的 150 名患者中，有 135 名患者被纳入研究。平均而言，患者在诊断为帕金森病时为 49 岁，开始输注治疗时为 63 岁。输注的中位治疗时间为 3.4 年（范围为 0-16 年）。限制平均治疗时间接近 8 年；在研究结束时，仍有 81 名患者在接受治疗。大多数患者使用左旋多巴作为单一疗法。随着时间的推移，药物的剂量保持稳定。在截止日期之前，有 31 名患者停止了输注，有 23 名患者死亡。设备相关问题是最常见的停药原因。在 2000 年之前，患者更有可能停止输注治疗。与继续治疗的匹配组相比，脱落组开始输注的年份更早。
左旋多巴/卡比多巴肠凝胶输注是晚期帕金森病患者的一种长期治疗选择。
