Transcutaneous port for continuous duodenal levodopa/carbidopa administration in Parkinson's disease

Mov Disord. 2011 Feb 1;26(2):331-4. doi: 10.1002/mds.23408. Epub 2010 Oct 19.

Abstract

Motor fluctuations in Parkinson's disease (PD) can be reduced by intraduodenal infusion of levodopa-carbidopa (Duodopa®) via percutaneous endoscopic gastrojejunostomy (PEG). We applied the transcutaneous soft-tissue anchored titanium port (T-port) in 15 PD patients with motor fluctuations; 7 Duodopa-naive (non-PEG), and 8 previously receiving Duodopa (former-PEG). Motor scores (UPDRS-III) and quality of life (QOL, PDQ-8) were assessed at baseline and 6 month follow-up. Six patients had local irritation shortly after implantation, persisting in one patient at 6 month follow-up, which led to explantation. After having finished the protocol, four T-ports were explanted in total. UPDRS-III and PDQ-8 scores improved moderately in the non-PEG patients, but remained similar in the former-PEG users. Two former-PEG users developed polyneuropathy. No obstructions, retractions, or leakages occurred. Technical and hygienic properties of the T-port were preferred by most patients. The T-port seems to be suitable for most PD patients qualifying for Duodopa therapy, although local infection may lead to explantation during longer-term follow-up.

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Aged
  • Antiparkinson Agents / administration & dosage*
  • Antiparkinson Agents / therapeutic use
  • Carbidopa / administration & dosage*
  • Carbidopa / therapeutic use
  • Drug Combinations
  • Duodenum*
  • Female
  • Humans
  • Levodopa / administration & dosage*
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Patient Satisfaction
  • Quality of Life
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Drug Combinations
  • Levodopa
  • Carbidopa