[Triple combination of levodopa, carbidopa and entacapone by intrajejunal pump in advanced Parkinson's disease]

Ideggyogy Sz. 2022 Nov 30;75(11-12):365-368. doi: 10.18071/isz.75.0365.
[Article in Hungarian]

Abstract

In advanced Parkinson's disease, oral medication can often no longer achieve sufficient therapeutic success. As one of the device aided therapies, the intrajejunal levo-dopa administration has been established as valuable treatment option. A modern form of the well-known intestinal levodopa pump offers the opportunity to continue the oral triple combination of levodopa, carbidopa and entacapone that many patients already use. Since February 2021 this modern option is available in Austria and Germany which also contains entacapone, whereby levo-dopa can be saved. In many other countries, including Hungary, approval is expected in the near future. The pump and cartridge are significantly smaller and lighter than in the LCIG pump which should improve the accep-tance of the therapy. The higher acceptance of the smaller pump and the improved user-friendliness has already been reported in an observational study from Sweden. The unwanted effects of entacapone have to be considered.

<p>Előrehaladott Parkinson-k&oacute;rban a sz&aacute;jon &aacute;t adhat&oacute; gy&oacute;gyszeres kezel&eacute;s gyakran nem &eacute;ri el a kellő ter&aacute;pi&aacute;s hat&aacute;st. Az eszk&ouml;zt&aacute;mogatott ter&aacute;pi&aacute;s m&oacute;dszerek egyike, a levodopa intrajejunalis adagol&aacute;sa, &eacute;rt&eacute;kes alternat&iacute;v&aacute;nak bizonyult. A j&oacute;l ismert intestinalis levodopapumpa egy modern v&aacute;ltozata lehetőv&eacute; teszi a levodopa, karbidopa &eacute;s entakapon or&aacute;lis h&aacute;rmas kombin&aacute;ci&oacute;j&aacute;nak tov&aacute;bbi alkal&shy;maz&aacute;s&aacute;t, amellyel sok beteg m&aacute;r előzőleg kezelve volt. Ez, az entakapont is tartalmaz&oacute;, modern kezel&eacute;si lehetős&eacute;g 2021. febru&aacute;r &oacute;ta &eacute;rhető el Ausztri&aacute;ban &eacute;s N&eacute;met&shy;orsz&aacute;g&shy;ban &eacute;s a levodopad&oacute;zis cs&ouml;kkent&eacute;s&eacute;t is eredm&eacute;nyezheti az intestinalis levodopad&oacute;zishoz (LCIG) viszony&iacute;tva. A k&ouml;zel&shy;j&ouml;vőben sz&aacute;mos m&aacute;s orsz&aacute;gban, k&ouml;zt&uuml;k Magyarorsz&aacute;gon is egyedi t&aacute;mogat&aacute;ssal ig&eacute;nyelhető. A pumpa &eacute;s az in&shy;tes&shy;tinalis g&eacute;lt tartalmaz&oacute; patron l&eacute;nyegesen kisebb &eacute;s k&ouml;nnyebb, mint az LCIG-pumpa, ami jav&iacute;tja a ter&aacute;pia elfogadotts&aacute;g&aacute;t. Egy Sv&eacute;dorsz&aacute;gban v&eacute;gzett tanulm&aacute;ny a kisebb pumpa magasabb elfogadotts&aacute;gi ar&aacute;ny&aacute;r&oacute;l &eacute;s felhaszn&aacute;l&oacute;bar&aacute;tabb kezel&eacute;sről sz&aacute;molt be a betegek k&ouml;r&eacute;ben. Azonban az entakapon esetlegesen fell&eacute;pő nem&shy;k&iacute;v&aacute;nt mell&eacute;khat&aacute;sait nem szabad figyelmen k&iacute;v&uuml;l hagyni.</p>.

Keywords: LECIG; advanced Parkinson’s disease; device-aided therapies; intrajejunal pump; levodopa.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Carbidopa*
  • Drug Combinations
  • Gels / therapeutic use
  • Humans
  • Levodopa / therapeutic use
  • Observational Studies as Topic
  • Parkinson Disease* / drug therapy

Substances

  • Carbidopa
  • Levodopa
  • entacapone
  • Antiparkinson Agents
  • Drug Combinations
  • Gels