Öthman Mezin, Widman Erik, Nygren Ingela, Nyholm Dag
Department of Neuroscience, Neurology, Uppsala University, SE-75185 Uppsala, Sweden.
J Pers Med. 2021 Mar 31;11(4):254. doi: 10.3390/jpm11040254.
Patients in fluctuating stages of Parkinson's disease (PD) require device-aided treatments. Continuous infusion of levodopa-carbidopa intestinal gel (LCIG) is a well-proven option in clinical practice. We now report the first clinical experience of levodopa-entacapone-carbidopa intestinal gel (LECIG) therapy. An observational study of the first patients to start LECIG in our clinic was performed. Twenty-four patients (11 females, 13 males) were included. The median age was 71.5 years, and the median duration since PD diagnosis was 15.5 years. The median treatment duration was 305 days. Median doses were: 6.0 mL as morning dose, 2.5 mL/h as infusion rate, and 1.0 mL as extra dose. Half of the patients were switched directly from LCIG. These patients express improvements in the size and weight of the pump. Furthermore, most of them considered the new pump to be improved regarding user-friendliness. Six patients discontinued LECIG, three due to diarrhea, one due to hallucinations and two deceased (one cardiac arrest and one COVID-19). LECIG has shown to be possible to use in patients with PD, efficacy and safety as expected. Patients are generally happy with the size and usability of the pump, but some technical improvements of the software are warranted, as well as larger, prospective studies.
处于帕金森病（PD）波动期的患者需要借助设备进行治疗。左旋多巴-卡比多巴肠凝胶（LCIG）持续输注在临床实践中是一种经过充分验证的选择。我们现在报告左旋多巴-恩他卡朋-卡比多巴肠凝胶（LECIG）治疗的首例临床经验。对我们诊所首批开始使用LECIG的患者进行了一项观察性研究。纳入了24例患者（11例女性，13例男性）。中位年龄为71.5岁，自PD诊断以来的中位病程为15.5年。中位治疗持续时间为305天。中位剂量为：早晨剂量6.0 mL，输注速率2.5 mL/h，额外剂量1.0 mL。一半的患者直接从LCIG转换而来。这些患者表示泵的尺寸和重量有所改善。此外，他们中的大多数人认为新泵在用户友好性方面有所改进。6例患者停止使用LECIG，3例因腹泻，1例因幻觉，2例死亡（1例心脏骤停，1例死于COVID-19）。LECIG已证明可用于PD患者，疗效和安全性符合预期。患者总体上对泵的尺寸和可用性感到满意，但软件的一些技术改进是必要的，同时也需要更大规模的前瞻性研究。
