Abstract Details

Title Intrajejunal Levodopa Infusion for Parkinson's Disease over 11 years: A Canadian Experience

Topic Movement Disorders

Presentation(s) P13 - Poster Session 13 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-014

Objective To analyze long-term experience in the clinical management of Parkinson's disease (PD) patients with intrajejunal levodopa infusion (ILI) therapy over 11 years.

Background ILI therapy is a safe and effective drug delivery method for advanced Parkinson’s disease with proven short-term efficacy and safety profile. Limited data is available regarding long-term benefits and complications. ILI is done at the University of Alberta Hospital in a multidisciplinary clinic including neurology, gastroenterology, psychiatry, PT, OT, and specialized nursing.

Design/Methods Retrospective chart review was done for patients with PD who underwent ILI from 2011 to 2022. Data collected included dosing, UPDRS-III motor scores, OFF times, hours with dyskinesias, MoCA scores, complications, discontinuation reasons, and nursing time requirements.

Results Thirty-three patients received ILI therapy with a mean follow up of 3.25 + 2.09 years. Over 11 years, 6 (18.1%) patients discontinued treatment due to side effects or lack of efficacy, 2 (6.06%) transitioned to DBS therapy, and 11 (33.3%) died of causes unrelated to ILI infusion. One patient died from haematemesis related to a coiled PEG-J tube. UPDRS-III score showed relative reduction by 16.3% from baseline (mean 33) maintained for 4 years (mean 28). Mean daily OFF time improved from baseline (mean 7.1+3.13 hours) up to 5 years (mean 3.3+2.31 hours; -73.07%; p - 0.048). Dyskinesias remained stable. Nursing time averaged 22 hours per patient per year after PEG-J insertion and titration. Most common complications were PEG-J tube dislodgement and pump malfunction in 18 (54.5%) patients over the study period.

Conclusions Patients on ILI had improved motor scores, reduced OFF-times, and stable dyskinesias over 5-year follow-up. Most common complication was PEG-J dislodgement; serious complications were uncommon. Nursing time requirements necessitate ILI trained nurses.

Authors/Disclosures
Oksana Suchowersky, MD, FAAN (University of Alberta Hospital) PRESENTER	Dr. Suchowersky has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Syneos/Alexion. The institution of Dr. Suchowersky has received research support from Roche. The institution of Dr. Suchowersky has received research support from Wave LifeSciences. The institution of Dr. Suchowersky has received research support from CHDI. Dr. Suchowersky has received publishing royalties from a publication relating to health care. Dr. Suchowersky has received publishing royalties from a publication relating to health care.
	No disclosure on file
Moath Hamed, MD (NYP Brooklyn Methodist)	Dr. Hamed has nothing to disclose.
	No disclosure on file
	No disclosure on file
Aakash S. Shetty, MD	Dr. Shetty has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Shetty has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Parkinson Canada.
	No disclosure on file

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