Outcomes Impacting Quality of Life in Advanced Parkinson's Disease Patients Treated with Levodopa-Carbidopa Intestinal Gel

J Parkinsons Dis. 2022;12(3):917-926. doi: 10.3233/JPD-212979.

Abstract

Background: It is believed that motor symptoms, including dyskinesia, and non-motor symptoms impact health-related quality of life (HRQoL) in patients with Parkinson's disease (PD), and that improvements in these metrics are correlated.

Objective: Investigate the relationship between HRQoL and measures of PD severity and treatment efficacy, including motor and non-motor symptoms.

Methods: This was a planned investigation of an international, prospective, single-arm, post-marketing observational study of the long-term effectiveness of levodopa-carbidopa intestinal gel (LCIG) in patients with advanced PD. Pearson correlation coefficients (PCC) were calculated for baseline and change from baseline at 12 months between HRQoL and motor and non-motor symptoms.

Results: A total of 195 patients were included. At baseline, HRQoL was moderately positively correlated with Activities of Daily Living (UPDRS II, PCC = 0.44), non-motor symptoms (0.48), and measures of sleep (0.50 and 0.40); all p < 0.001. After 12 months of treatment with LCIG, improvements in HRQoL were moderately positively correlated with improvement from baseline in non-motor symptoms (PCC = 0.42), sleep (0.54), and daytime sleepiness (0.40; all p < 0.001), and weakly correlated with improvement in dyskinesia signs and symptoms (PCC = 0.23; p = 0.011). Improvement in HRQoL was not correlated with improvements in OFF time or dyskinesia time.

Conclusion: Both at baseline and for change from baseline at 12 months, HRQoL was correlated with baseline and change from baseline in dyskinesia, Activities of Daily Living, and non-motor symptoms, including sleep; but not with baseline or change in OFF time.

Keywords: Dyskinesia; Parkinson’s disease; health-related quality of life; levodopa-carbidopa intestinal gel; non-motor symptoms.

Publication types

  • Observational Study

MeSH terms

  • Activities of Daily Living
  • Antiparkinson Agents / therapeutic use
  • Carbidopa* / therapeutic use
  • Drug Combinations
  • Dyskinesias
  • Gels
  • Humans
  • Levodopa* / therapeutic use
  • Parkinson Disease* / drug therapy
  • Prospective Studies
  • Quality of Life

Substances

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