Real‐life benefits of intrajejunal levodopa infusion therapy in four patients with the parkinsonian variant of progressive supranuclear palsy: A 1‐year follow‐up data report

Background Progressive supranuclear palsy (PSP) is a progressive neurodegenerative condition presenting with different clinical endophenotypes. The parkinsonian variant of PSP (PSP‐P) is characterised by early but fading responsiveness to high‐dose levodopa therapy; however, high‐dose oral therapy i...

Full description

Saved in:
Bibliographic Details
Published in:Brain and behavior Vol. 12; no. 9; pp. e2547 - n/a
Main Authors: Metta, Vinod, Chaudhuri, K. Ray, Leta, Valentina, Mridula, Kandadai Rukmini, Koduri, Chaitanya, Deepak, Sai, Kalpala, Rakesh, Reddy, Nageswar, Chung‐Faye, Guy, Borgohain, Rupam
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01.09.2022
John Wiley and Sons Inc
Wiley
Subjects:
Antiparkinson Agents - therapeutic use
Cosmetics
Dementia
Diabetes
Dopamine
Drug dosages
Family medical history
Follow-Up Studies
Gait
Hallucinations
Hospitals
Humans
Hypertension
intrajejunal levodopa‐carbidopa infusion
Levodopa - adverse effects
motor and nonmotor symptoms
Original
Parkinson Disease
Parkinson's disease
Parkinsonian variant of progressive supranuclear palsy
Patients
Quality of Life
Sleep
Supranuclear Palsy, Progressive
India
intrajejunal levodopa-carbidopa infusion
Parkinsonian variant of progressive supranuclear palsy
motor and nonmotor symptoms
quality of life
ISSN:2162-3279, 2162-3279
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Progressive supranuclear palsy (PSP) is a progressive neurodegenerative condition presenting with different clinical endophenotypes. The parkinsonian variant of PSP (PSP‐P) is characterised by early but fading responsiveness to high‐dose levodopa therapy; however, high‐dose oral therapy is often associated with intolerance due to dopaminergic side effects and so doses may have to be capped despite clinical benefits. Evidence from animal models and real‐life registries suggest far higher doses of levodopa can be tolerated if given in a continuous drug delivery (CDD) manner. We investigated tolerance and possible clinical benefits in patients with PSP‐P still responsive to levodopa after initiating CDD in the form of intrajejunal levodopa infusion (IJLI) therapy as part of a compassionate usage program (CU). Methods This is an observational clinical data report from the IJLI implementation program undertaken in regional tertiary referral Parkinson's centres in India and at King's College Hospital London, Dubai as part of a CU. Four patients with PSP‐P receiving IJLI as a part of a CU underwent evaluations of liver and renal function, motor and nonmotor function, quality of life, sleep dysfunction, fatigue, anxiety and depression, and cognitive impairment at baseline and 6 and 12 months post‐IJLI initiation. Results In total, three out of four patients successfully completed 12 months of treatment (6 months in one patient). All four patients showed good tolerability to IJLI even at higher doses (1400 and 1960 mg at 6 and 12 months, respectively) when compared to oral levodopa (812.5 ± 103 levodopa equivalent daily dose [LEDD]) and presented with overall persistent improvements in motor and nonmotor scores and quality‐of‐life scores at 6 and 12 months post‐IJLI. All patients showed improvement in estimated glomerular filtration rate (43.50 ml/min/1.73 m2 to 67.5 ml/min/1.73 m2 and 79.5 ml/min/1.73 m2 at 6 and 12 months, respectively). Conclusions IJLI led to persistent beneficial effects on motor and some nonmotor aspects in patients with PSP‐P at up to 12 months after treatment with associated improvement in overall renal function. Intrajeujunal levodopa infusion for patients with Progressive supranuclear palsy‐Parkinson's variant
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:2162-3279
2162-3279
DOI:10.1002/brb3.2547