Impact of carbidopa-levodopa enteral suspension on quality of life and activities of daily living in patients with advanced Parkinson's disease: Results from a pooled meta-analysis.

Abstract

INTRODUCTION:

To estimate the impact of carbidopa/levodopa enteral suspension (CLES) on key patient-centered outcomes in patients with advanced Parkinson's disease (PD).

METHODS:

A comprehensive literature review identified relevant studies, from which data were meta-analyzed over 3-month intervals up to 24 months. Patient-centered outcomes of interest included mean (95% CI) changes from baseline (Δ) in quality of life (QoL), measured using PD-specific (PDQ-8, PDQ-39) and generic (EQ-5D) instruments; activities of daily living (ADL), measured in On and Off states using UPDRS Part II; and motor symptoms (i.e., Off time/day and motor examination [measured in On and Off states using UPDRS Part III]).

RESULTS:

The pooled meta-analysis included data from 26 studies evaluating 1556 patients on CLES. At 3 months, all outcomes showed significant improvement: QoL (ΔPDQ-39 = -10.26 [-11.54, -8.97], ΔEQ-5DVAS = 15.42 [12.58, 18.26]); ADL (ΔUPDRS IION = -4.32 [-5.63, -3.01]); motor symptoms (ΔOff time hours/day = -3.48 [-4.15, -2.82], ΔUPDRS IIION = -6.20 [-9.88, -2.51]). At 24 months, there were statistically significant mean improvements in QoL (ΔPDQ-39 = -7.74 [-12.40, -3.07], ΔEQ-5DVAS = 11.18 [6.90, 15.45]) and ADL (ΔUPDRS IIOFF = -3.88 [-5.34, -2.42]), and Off time (-4.21 [-5.16, -3.26] hours/day).

CONCLUSIONS:

Impact of CLES on significantly reducing Off time/day was observed to be rapid and durable (i.e., remained consistent across 24 months). Most QoL and ADL measures showed a consistent pattern of improvement with initiation of treatment and remained significantly improved from baseline at 24 months.

• Authors: David G Standaert, Vardhaman Patel, Sonya J Snedecor, Sandeep Thakkar, Yash J Jalundhwala, Pavnit Kukreja, David Kratochvil, Yanjun Bao, Rajesh Pahwa
• Journal: Parkinsonism & related disorders (Parkinsonism Relat Disord) Vol. 86 Pg. 52-57 (05 2021) ISSN: 1873-5126 [Electronic] England
• PMID: 33857722 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Antiparkinson Agents
• Drug Combinations
• Gels
• carbidopa, levodopa drug combination
• Levodopa
• Carbidopa

Topics

• Activities of Daily Living
• Antiparkinson Agents (administration & dosage)
• Carbidopa (administration & dosage)
• Drug Combinations
• Gels
• Humans
• Infusion Pumps, Implantable
• Levodopa (administration & dosage)
• Parkinson Disease (drug therapy)
• Quality of Life