The Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, People's Republic of China.
The Department of General Surgery, The Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 310000, People's Republic of China.
Drug Des Devel Ther. 2020 Feb 26;14:845-854. doi: 10.2147/DDDT.S229621. eCollection 2020.
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.
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.
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.
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.
左旋多巴-卡比多巴肠凝胶（LCIG）是一种新的给药方式，可使晚期帕金森病（PD）患者的左旋多巴血浆浓度更稳定，并有效减少运动障碍和运动障碍。
电子数据库检索截至 2018 年 1 月 1 日。本综述的纳入标准如下：LCIG 与晚期 PD 患者的口服药物相比。
五项试验，共 198 名患者，符合所有纳入标准。这些研究的质量评分范围为 3 至 5 分。两项临床试验表明，与口服药物相比，LCIG 在晚期 PD 患者中更有效地治疗定时伴麻烦性运动障碍（TSD）（= 0.02）和定时无 TSD（<0.00001）。此外，五项研究中的四项表明，LCIG 可能比口服药物更有效地改善 UPDRS 评分，两项研究发现 LCIG 对改善 PDQ-39 评分更有效。录像结果表明 LCIG 治疗患者的运动障碍和“关闭”状态都有潜在下降。LCIG 和口服药物组的不良反应发生率无显著差异。
与口服治疗相比，LCIG 的有效性主要通过减少定时伴 TSD 的时间、增加定时无 TSD 的时间和 UPDRS 和 PDQ-39 的评分来实现。这表明 LCIG 可能成为一种新的临床应用给药方式。然而，由于方法学上的缺陷，这些发现应谨慎看待，需要更多的 RCT 来补充我们的发现。
