Levodopa-carbidopa intestinal gel for advanced Parkinson's disease: Impact of LRRK2 and GBA1 mutations

Parkinsonism Relat Disord. 2024 Oct:127:107115. doi: 10.1016/j.parkreldis.2024.107115. Epub 2024 Aug 28.

Abstract

Background: Advanced Parkinson's disease (PD) can be treated with Levodopa-Carbidopa Intestinal Gel (LCIG).

Objective: To compare descriptive data of LCIG treatment in GBA1-PD and LRRK2-PD.

Methods: This multicenter retrospective study compared clinical data obtained from electronic medical records of PD patients treated with LCIG. Patients were grouped based on their genetic status.

Results: Fifty-two iPD, 15 LRRK2-PD and 23 GBA1-PD were included in this study. No difference in daily dose of LCIG or levodopa equivalent daily dose were detected. GBA1-PD had significantly shorter disease duration at LCIG initiation (p = 0.01) and experienced more hallucinations (p = 0.03) compared with LRRK2-PD and iPD. LRRK2-PD and iPD had significantly longer duration of LCIG treatment compared with GBA1-PD (p < 0.01).

Conclusion: Overall, LCIG treatment was well tolerated in LRRK2-PD and GBA1-PD. GBA1-PD required LCIG earlier in their course of their disease and had higher frequencies of hallucinations during treatment, attesting to a more severe disease course.

Keywords: GBA1; Levodopa-carbidopa intestinal gel; Parkinson's disease LRRK2.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents* / administration & dosage
  • Carbidopa* / administration & dosage
  • Carbidopa* / pharmacology
  • Drug Combinations*
  • Female
  • Gels*
  • Glucosylceramidase* / genetics
  • Humans
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2* / genetics
  • Levodopa* / administration & dosage
  • Levodopa* / pharmacology
  • Male
  • Middle Aged
  • Mutation*
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / genetics
  • Retrospective Studies

Substances

  • Carbidopa
  • Levodopa
  • Drug Combinations
  • Leucine-Rich Repeat Serine-Threonine Protein Kinase-2
  • Glucosylceramidase
  • LRRK2 protein, human
  • carbidopa, levodopa drug combination
  • GBA protein, human
  • Antiparkinson Agents
  • Gels