Assess the real-world effect of age on the long-term effectiveness and safety of levodopa-carbidopa intestinal gel (LCIG) treatment in patients with advanced Parkinson's disease (PD).

Limited data on how age may impact LCIG effectiveness and safety exist.

DUOGLOBE (NCT02611713) was a prospective, multinational, 3-year, observational study of LCIG-naïve patients treated in routine clinical practice. This post hoc analysis assessed change from baseline in “Off” time, Unified Dyskinesia Rating Scale (UDysRS), Non-Motor Symptom Scale (NMSS), Parkinson’s Disease Sleep Scale (PDSS-2), Unified Parkinson’s Disease Rating Scale (UPDRS) II and III, Parkinson’s disease Questionnaire 8 (PDQ-8), and serious adverse events (SAEs) by age (<65, 65–75, >75 years of age). Measurements up to month (M) 36 were analyzed.

Among 195 patients, 44/95/56 patients were aged <65/65–75/>75 years (range: 43–90 years), with a PD duration of 9.4/11.4/12.6 years, respectively. All groups showed highly significant improvements in “Off” time through M36 (P<.001). UDysRS significantly improved at M12 for <65 and through M24 in 65–75 (both P<.01). Patients <65 showed the greatest significant and sustained improvements through M36 in NMSS (P<.001), and PDSS-2 (P<.01) total scores. UPDRS II scores worsened the least in <65 over time. Patients <65 showed numerical improvements in UPDRS III scores through M36; scores significantly worsened in other groups (P<.05). PDQ-8 scores showed the greatest significant improvement in <65 through M24 (P<.01), and significant improvements at M12 in 65–75 (P<.01). SAEs and discontinuation rates were lower in patients <65 and were similar in 65–75 and >75 groups.

This post hoc analysis of a large observational study suggests that patients of various ages may benefit from LCIG treatment, with patients >75 having a comparable safety profile with 65–75, and improvements in patients <65 appeared more pronounced for some outcomes; further research is needed.