Top

Published in:

01-09-2018 | Original Communication

Assessment of Duodopa^® effects on quality of life of patients with advanced Parkinson’s disease and their caregivers

Authors: Rosella Ciurleo, Francesco Corallo, Lilla Bonanno, Viviana Lo Buono, Giuseppe Di Lorenzo, Roberta Versaci, Cettina Allone, Rosanna Palmeri, Placido Bramanti, Silvia Marino

Published in: Journal of Neurology | Issue 9/2018

Abstract

The gold standard of treatment in Parkinson’s disease (PD) is levodopa/carbidopa whose long-term use induces motor and non-motor fluctuations and dyskinesias. Continuous infusion of intrajejunal levodopa/carbidopa intestinal gel (Duodopa^®) reduces motor and non-motor symptoms and dyskinesias, and improves the quality of life of patients. The aim of this open observational prospective study was to evaluate the impact of Duodopa^® on conditions of PD patients and caregivers, and their quality of life. We enrolled 12 patients with advanced PD and their caregivers. The PD patients were assessed at baseline, 3 and 6 months after Duodopa^® treatment initiation using Unified Parkinson’s Disease Rating Scale-Part III and IV (UPDRS-III and IV), Unified Dyskinesia Rating Scale (UdysRS), Beck Depression Inventory (BDI-II), Hamilton Anxiety Rating Scale (HAM-A) and Parkinson’s Disease Quality of Life Questionnaire (PDQ-39). The caregivers were assessed, at the same time as the patients, using BDI-II, HAM-A, Caregiver Burden Inventory (CBI) and SF-36 Health Status Questionnaire. Six months after Duodopa^® therapy, the scores of UPDRS-III and IV, UdysRS, BDI-II, HAM-A and PDQ-39 were significantly decreased (p < 0.01). After Duodopa^® therapy, in caregiver group the scores of BDI-II, HAM-A and CBI were significantly decreased and the scores of SF-36 Health Status Questionnaire were significantly increased (p < 0.01). A reduction of anxiety after therapy correlated with mental status domains of SF-36 Health Status Questionnaire (r = 0.56). Overall, Duodopa^® is effective even in the short time to improve the clinical conditions of PD patients and caregivers and their quality of life.

Obeso JA, Rodriguez-Oroz MC, Rodriguez M, Lanciego JL, Artieda J, Gonzalo N et al (2000) Pathophysiology of the basal ganglia in Parkinson’s disease. Trends Neurosci 23:S8–S19CrossRefPubMed

Fox SH, Katzenschlager R, Lim SY, Ravina B, Seppi K, Coelho M et al (2011) The movement disorder society evidence-based medicine review update: treatments for the motor symptoms of Parkinson’s disease. Mov Disord 26(Suppl 3):S2–S41. https://doi.org/10.1002/mds.23829 CrossRefPubMed

Ahlskog JE, Muenter MD (2001) Frequency of levodopa-related dyskinesias s and motor fluctuations as estimated from the cumulative literature. Mov Disord 16:448–458. https://doi.org/10.1002/mds.1090 CrossRefPubMed

Gunal DI, Nurichalichi K, Tuncer N, Bekiroglu N, Aktan S (2002) The clinical profile of nonmotor fluctuation in Parkinson’s disease patients. Can J Neurol Sci 29:61–64CrossRefPubMed

Cedarbaum JM (1987) Clinical pharmacokinetics of anti-Parkinsonian drugs. Clin Pharmacokinet 13:141–178CrossRefPubMed

Nutt JG (2008) Pharmacokinetics and pharmacodynamics of levodopa. Mov Disord 23:S580–S584. https://doi.org/10.1002/mds.22037 CrossRefPubMed

Mouradian MM, Juncos JL, Fabrini G, Chase TN (1989) Motor fluctuations in Parkinson’s disease. Ann Neurol 25:633–634CrossRef

Obeso JA, Grandas F, Vaamonde J, Luquin MR, Artieda J, Lera G et al (1989) Motor complications associated with chronic levodopa therapy in Parkinson’s disease. Neurology 39:337–345

Chapuis S, Ouchchane L, Metz O, Gerbaud L, Durif F (2005) Impact of the motor complications of Parekinson’s disease on the quality of life. Mov Disord 20:224–230. https://doi.org/10.1002/mds.20279 CrossRefPubMed

10.

Storch A, Schneider CB, Wolz M, Stürwald Y, Nebe A, Odin P et al (2013) Nonmotor fluctuations in Parkinson desease: severity and correlation with motor complications. Neurology 80:800–809. https://doi.org/10.1212/WNL.0b013e318285c0ed CrossRefPubMed

11.

Palmeri R, Lo Buono V, Corallo F, Foti M, Di Lorenzo G, Bramanti P et al (2017) Nonmotor symptoms in Parkinson disease: a descriptive review on social cognition ability. J Ger Psych Neurol 30:109–121. https://doi.org/10.1177/0891988716687872 CrossRef

12.

Witjas T, Kaphan E, Azulay JP, Blin O, Ceccaldi M, Pouget J et al (2002) Nonmotor fluctuations in Parkinson’s disease: frequent and disabling. Neurology 59:408–441CrossRefPubMed

13.

Martinez-Martin P, Forijaz MJ, Frades-Pyo B, Rusiñol AB, Fernández-García JM, Benito-León J et al (2007) Caregiver burden in Parkinson’s disease. Mov Disord 22:924–931. https://doi.org/10.1002/mds.21355 CrossRefPubMed

14.

Martinez-Martin P, Arroyo S, Rojo-Abuin JM, Rodriguez-Blazquez C, Frades B, de Pedro Cuesta J (2008) Longitudinal Parkinson’s Disease Patient Study (Estudio longitudinal de pacientes con enfermedad de Parkinson-ELEP) Group. Burden, perceived health status, and mood among caregivers of Parkinson’s disease patients. Mov Disord 23:1673–1680. https://doi.org/10.1002/mds.22106 CrossRefPubMed

15.

Rascol O, Perez-Lloret S, Ferreira JJ (2015) New treatments for levodopa-induced motor complications. Mov Disord 30:1451–1460. https://doi.org/10.1002/mds.26362 CrossRefPubMed

16.

LeWitt PA (2016) New levodopa therapeutic strategies. Parkinsonism Relat Disord 22:S37–S40. https://doi.org/10.1016/j.parkreldis.2015.09.021 CrossRefPubMed

17.

Politis M, Sauerbier A, Loane C, Pavese N, Martin A, Corcoran B et al (2017) Sustained striatal dopamine levels following intestinal levodopa infusions in Parkinson’s disease patients. Mov Disord 32:235–240. https://doi.org/10.1002/mds.26848 CrossRefPubMed

18.

De Fabregues O, Dot J, Abu-Suboh M, Hernández-Vara J, Ferré A, Romero O et al (2017) Long-term safety and effectiveness of levodopa–carbidopa intestinal gel infusion. Brain Behav 7:e00758. https://doi.org/10.1002/brb3.758 CrossRefPubMedPubMedCentral

19.

Antonini A, Poewe W, Chaudhuri KR, Jech R, Pickut B, Pirtošek Z et al (2017) Levodopa–carbidopa intestinal gel in advanced Parkinson’s: Final results of the GLORIA registry. Parkinsonism Relat Disord 45:13–20. https://doi.org/10.1016/j.parkreldis.2017.09.018 CrossRefPubMed

20.

Antonini A, Isaias IU, Canesi M, Zibetti M, Mancini F, Manfredi L et al (2007) Duodenal levodopa infusion for advanced Parkinson’s disease: 12-month treatment outcome. Mov Disord 22:1145–1149. https://doi.org/10.1002/mds.21500 CrossRefPubMed

21.

Antonini A, Mancini F, Canesi M, Zangaglia R, Isaias IU, Manfredi L et al (2008) Duodenal levodopa infusion improves quality of life in advanced Parkinson’s disease. Neurodegener Dis 5:244–246. https://doi.org/10.1159/000113714 CrossRefPubMed

22.

Antonini A, Yegin A, Preda C, Bergmann L, Poewe W, GLORIA study Investigators and Coordinators (2015) Global long-term study on motor and non-motor symptoms and safety of levodopa–carbidopa intestinal gel in routine care of advanced Parkinson’s disease patients; 12-month interim outcomes. Parkinsonism Relat Disord 21:231–235. https://doi.org/10.1016/j.parkreldis.2014.12.012 CrossRefPubMed

23.

Eggert K, Schrader C, Hahn M, Stamelou M, Rüssmann A, Dengler R et al (2008) Continuous jejunal levodopa infusion in patients with advanced Parkinson’s disease: practical aspects and outcome of motor and non-motor complications. Clin Neuropharmacol 31:151–166. https://doi.org/10.1097/wnf.0b013e31814b113e CrossRefPubMed

24.

Honig H, Antonini A, Martinez-Martin P, Forgacs I, Faye GC, Fox T et al (2009) Intrajejunal levodopa infusion in Parkinson’s disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. Mov Disord 24:1468–1474. https://doi.org/10.1002/mds.22596 CrossRefPubMed

25.

Pålhagen SE, Dizdar N, Hauge T, Holmberg B, Jansson R, Linder J et al (2012) Interim analysis of long-term intraduodenal levodopa infusion in advanced Parkinson disease. Acta Neurol Scand 126:29–33. https://doi.org/10.1111/j.1600-0404.2012.01689.x CrossRef

26.

Zibetti M, Merola A, Ricchi V, Marchisio A, Artusi CA, Rizzi L et al (2013) Long-term duodenal levodopa infusion in Parkinson’s disease: a 3-year motor and cognitive follow-up study. J Neurol 260:105–114. https://doi.org/10.1007/s00415-012-6597-0 CrossRefPubMed

27.

Zibetti M, Merola A, Artusi CA, Rizzi L, Angrisano S, Reggio D et al (2014) Levodopa/carbidopa intestinal gel infusion in advanced Parkinson’s disease: a 7-year experience. Eur J Neurol 21:312–318. https://doi.org/10.1111/ene.12309 CrossRefPubMed

28.

Foltynie T, Magee C, James C, Webster GJ, Lees AJ, Limousin P (2013) Impact of duodopa on quality of life in advanced Parkinson’s disease: a UK case series. Parkinsons Dis 2013:362908. https://doi.org/10.1155/2013/362908 PubMedPubMedCentralCrossRef

29.

Bohlega S, Abou Al-Shaar H, Alkhairallah T, Al-Ajlan F, Hasan N, Alkahtani K (2015) Levodopa–carbidopa intestinal gel infusion therapy in advanced Parkinson’s disease: single middle eastern center experience. Eur Neurol 74:227–236. https://doi.org/10.1159/000442151 CrossRefPubMed

30.

Fernandez HH, Standaert DG, Hauser RA, Lang AE, Fung VS, Klostermann F et al (2015) Levodopa–carbidopa intestinal gel in advanced Parkinson’s disease: final 12-month. Open-label results. Mov Disord 30:500–509. https://doi.org/10.1002/mds.26123 CrossRefPubMed

31.

Bellante F, Dethy S, De Beyl DZ (2016) Depression, anxiety and non-motor symptoms on initiation ogf intrajejunal levodopa/carbodopa therapy. Acta Neurol Belg 116:39–41. https://doi.org/10.1007/s13760-015-0497-x CrossRefPubMed

32.

Fasano A, Ricciardi L, Lena F, Bentivoglio AR, Modugno N (2012) Intrajejunal levodopa infusion in advanced Parkinson’s disease: long-term effects on motor and non-motor symptoms and impact on patients’ and caregivers’ quality of life. Eur Rev Med Pharmacol Sci 16:79–89PubMed

33.

Santos-García D, Añón MJ, Fuster-Sanjurjo L, de la Fuente-Fernández R (2012) Duodenal levodopa/carbidopa infusion therapy in patients with advanced Parkinson’s disease leads to improvement in caregivers’ stress and burden. Eur J Neurol 19:1261–1265. https://doi.org/10.1111/j.1468-1331.2011.03630.x CrossRefPubMed

34.

Poewe W, Sampaio C, Stern MB, Dodel R, Dubois B, Holloway R, Movement Disorder Society UPDRS Revision Task Force et al (2008) Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Mov Disord 23:2129–2170. https://doi.org/10.1002/mds.22340 CrossRefPubMed

35.

Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699. https://doi.org/10.1111/j.1532-5415.2005.53221.x CrossRefPubMed

36.

Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J (1994) The Neuropsychiatric Inventory comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314CrossRefPubMed

37.

Nutt J (1999) A unified dyskinesias s rating scale for L-dopa-induced dyskinesias? Mov Disord 14(Suppl 1):74PubMed

38.

Beck AT, Steer RA, Brown GK (1996) Beck depression inventory-II. San Antonio, TX, p 78204

39.

Schneider H, Esbitt S, Gonzalez JS (2013) Hamilton anxiety rating scale. Encyclopedia of behavioral medicine. Springer, New York, pp 886–887

40.

Peto V, Jenkinson C, Fitzpatrick R (1998) PDQ-39: a review of the development, validation and application of a Parkinson’s disease quality of life questionnaire and its associated measures. J Neurol 245:S10–S14CrossRefPubMed

41.

Novak M, Guest C (1989) Application of a multidimensional caregiver burden inventory. Gerontologist 29:798–803CrossRefPubMed

42.

Bousquet J, Bullinger M, Fayol C, Marquis P, Valentin B, Burtin B (1994) Assessment of quality of life in patients with perennial allergic rhinitis with the French version of the SF-36 Health Status Questionnaire. J Allergy Clin Immunol 94:182–188. https://doi.org/10.1053/ai.1994.v94.a54939 CrossRefPubMed

43.

Terwee CB, Dekker FW, Wiersinga WM, Prummel MF, Bossuyt PMM (2003) On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res 12(4):349–362CrossRefPubMed

44.

Sullivan GM, Feinn R (2012) Using effect size—or why the P value is not enough. J Grad Med Educ 4(3):279–282CrossRefPubMedPubMedCentral

45.

Lutz SG, Holmes JD, Ready EA, Jenkins ME, Johnson AM (2016) Clinical presentation of anxiety in Parkinson’s Disease: a scoping review. OTJR (Thorofare N J) 36:134–147. https://doi.org/10.1177/1539449216661714 CrossRef

46.

Yamanishi T, Tachibana H, Oguru M, Matsui K, Toda K, Okuda B et al (2013) Anxiety and depression in patients with Parkinson’s disease. Intern Med 52:539–545. https://doi.org/10.2169/internalmedicine.52.8617 CrossRefPubMed

47.

Prakash KM, Nadkarni NV, Lye WK, Yong MH, Tan EK (2016) The impact of non-motor symptoms on the quality of life of Parkinson’s disease patients: a longitudinal study. Eur J Neurol 23:854–860. https://doi.org/10.1111/ene.12950 CrossRefPubMed

48.

Berganzo K, Tijero B, González-Eizaguirre A, Somme J, Lezcano E, Gabilondo I et al (2016) Motor and non-motor symptoms of Parkinson’s disease and their impact on quality of life and on different clinical subgroups. Neurologia 31:585–591. https://doi.org/10.1016/j.nrl.2014.10.010 CrossRefPubMed

49.

Foppa AA, Chemello C, Vargas-Peláez CM, Farias MR (2016) Medication therapy management service for patients with Parkinson’s disease: a before-and-after study. Neurol Ther 5:85–99. https://doi.org/10.1007/s40120-016-0046-4 CrossRefPubMedPubMedCentral

50.

Carter JH, Stewart BJ, Archbold PG, Parkinson’s Study Group et al (1998) Living with a person who has Parkinson’s disease: the spouse’s perspective by stage of disease. Mov Disord 13:20–28. https://doi.org/10.1002/mds.870130108 CrossRefPubMed

51.

Ozdilek B, Gunal DI (2012) Motor and non-motor symptoms in Turkish patients with Parkinson’s disease affecting family caregiver burden and quality of life. J Neuropsychiatry Clin Neurosci 24:478–483. https://doi.org/10.1176/appi.neuropsych.11100315 CrossRefPubMed

Title: Assessment of Duodopa® effects on quality of life of patients with advanced Parkinson’s disease and their caregivers
Authors: Rosella Ciurleo
Francesco Corallo
Lilla Bonanno
Viviana Lo Buono
Giuseppe Di Lorenzo
Roberta Versaci
Cettina Allone
Rosanna Palmeri
Placido Bramanti
Silvia Marino
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 9/2018
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-018-8951-3

At a glance: The STEP trials

Springer Medicine

Assessment of Duodopa^® effects on quality of life of patients with advanced Parkinson’s disease and their caregivers

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 9/2018

Correction to: Effectiveness of Rotigotine plus intensive and goal‑based rehabilitation versus Rotigotine alone in “de‑novo” Parkinsonian subjects: a randomized controlled trial with 18‑month follow‑up

Beyond 35 years of Parkinson’s disease: a comprehensive clinical and instrumental assessment

New treatments in Alzheimer’s disease

Prospective study of relevance of 123I-MIBG myocardial scintigraphy and clonidine GH test to distinguish Parkinson’s disease and multiple system atrophy

Extrapyramidal deficits in ALS: a combined biomechanical and neuroimaging study

Botulinum toxin therapy of hemifacial spasm: bilateral injections can reduce facial asymmetry