Living Alone Is Associated with Discontinuation of Levodopa-Entacapone-Carbidopa Intestinal Gel Treatment in Advanced...

Levodopa-entacapone-carbidopa intestinal gel (LECIG) is a recently introduced device-aided treatment option for advanced Parkinson's disease. Data on long-term outcomes remain limited, with only two published studies to date. This study aimed to report long-term outcomes of LECIG treatment, focusing on safety, adverse events, and treatment adherence.

In this retrospective longitudinal observational single-center study, the medical records of 27 consecutive patients treated with LECIG at Helsinki University Hospital between 2020 and 2024 were analyzed. Adverse events, treatment discontinuations, and medication changes were assessed during the first 2 years of treatment. Clinically significant weight loss was defined as weight loss of >5% over 12 months. Fisher's exact test was used to assess the association between living situation and treatment discontinuation.

In total, 10 patients (37%) discontinued the treatment, with 6 (60%) within the first year. Living alone was significantly associated with discontinuation (p = 0.033) compared to living with a spouse or in an institution. Three patients died during follow-up from causes unrelated to LECIG treatment. Adverse events were frequent, including inner tube complications requiring 41 inner tube replacements. Clinically significant weight loss was observed in 29% of patients.

In long-term treatment, adverse events with LECIG appear similar to those observed with levodopa-carbidopa intestinal gel (LCIG). However, weight loss and the discontinuation rate appear higher with LECIG. Yet, no direct comparison to LCIG was made in this study. Similar to LCIG, the discontinuation rate is particularly high among patients living alone.