[Treatment for advanced Parkinson's disease with intestinal levodopa/carbidopa gel: review of efficacy and safety].

Late stages of Parkinson's disease (PD) are characterized by the development of motor fluctuations and dyskinesia which inevitably emerge during the disease due to long-term use of levodopa and hinder treatment. The use of intestinal levodopa/carbidopa gel stabilizes the drug blood concentration and reduces the severity of motor parkinsonian symptoms. The literature of the last two decades on the efficacy and safety of intrarenal introduction of intestinal levodopa/carbidopa gel in PD patients is reviewed.A data analysis of intestinal levodopa/carbidopa gel revealed the efficacy of this method in the late stages of PD. The drug reduced motor symptoms, severity of motor fluctuations and dyskinesia and improved quality of life. Some studies demonstrated the decrease in PD stage, as evaluated by Hoehn and Yahr, during treatment with intestinal levodopa/carbidopa gel. The good tolerability profile allows for possibility of using this method for multiyear treatment. Side-effects were mostly related to drug delivery. All of them may be overcome in future in the process of technical improvement.