{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T22:13:15Z","timestamp":1769551995134,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,4]],"date-time":"2021-11-04T00:00:00Z","timestamp":1635984000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Levodopa\u2010carbidopa intestinal gel (LCIG) effectively reduces <jats:italic>off<\/jats:italic> time and dyskinesia and increases <jats:italic>on<\/jats:italic> time in advanced Parkinson's disease (PD). However, patients with LCIG\u2010infusion experience frequent complications and some discontinue treatment early on.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The objectives of this study were to find predictive factors for early dropout from the LCIG infusion, analyze the treatment burden on the tertiary health care system, and explore changes in medication during the LCIG treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>LCIG\u2010infusion was administrated to 103 patients between July 2006 and May 2020 at the Helsinki University Hospital, accumulating 350\u2009years of follow\u2010up data. We evaluated, retrospectively, changes in medication during treatment, discontinuation of the infusion, and adverse events from the patient records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Living alone was a predictive factor for early dropout (OR\u00a0=\u00a03.88; 95% CI\u00a0=\u00a01.03\u201314.66; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.045). The treatment burden on the tertiary health care system increased after the initiation of LCIG infusion mostly because of common complications related to the infusion system (median change of in\u2010 and out\u2010patient visits +1, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). Mean levodopa equivalent daily dose (LEDD) rose from baseline to 6\u2009months (1246.7 vs. 1684.9, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) and stabilized thereafter. Patients commonly switched from \u201cpolypharmacy\u201d to \u201cLCIG\u2010only\u201d or \u201cLCIG + oral levodopa\u201d medication\u2010groups during long\u2010term treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Recurrent complications related to the infusion system increase the treatment burden on tertiary healthcare system after the initiation of LCIG\u2010infusion. Most patients continue long\u2010term with the infusion. Few patients discontinue infusion during the first year after initiation and living alone appears to be a risk factor for this outcome.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13361","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T14:25:57Z","timestamp":1634739957000},"page":"60-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Single\u2010Center Study of 103 Consecutive Parkinson's Disease Patients with Levodopa\u2010Carbidopa Intestinal Gel"],"prefix":"10.1002","volume":"9","author":[{"given":"Vili","family":"Viljaharju","sequence":"first","affiliation":[{"name":"Department of Neurology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuomas","family":"Mertsalmi","sequence":"additional","affiliation":[{"name":"Department of Neurology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Amande M.","family":"Pauls","sequence":"additional","affiliation":[{"name":"Department of Neurology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7921-5412","authenticated-orcid":false,"given":"Maija","family":"Koivu","sequence":"additional","affiliation":[{"name":"Department of Neurology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Eerola\u2010Rautio","sequence":"additional","affiliation":[{"name":"Department of Neurology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Udd","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eero","family":"Pekkonen","sequence":"additional","affiliation":[{"name":"Department of Neurology Helsinki University Hospital  Helsinki Finland"},{"name":"Department of Clinical Neurosciences (Neurology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,11,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61393-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22037"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22021"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70293-X"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-016-0336-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28703"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8951-3"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12526"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.12.012"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27626"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22596"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27338"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-201978"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2012.03679.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-191605"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12309"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.09.018"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.10.004"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26485"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.05.014"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.02.020"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20962"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23429"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285616681280"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22450"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-013-1153-3"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5566-8"},{"issue":"6","key":"e_1_2_7_30_1","first-page":"861","article-title":"Intestinal levodopa infusion: the Belgian experience","volume":"35","author":"Pickut BA","year":"2014","journal-title":"Neurol Sci"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12688"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13361","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.13361","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.13361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:58:48Z","timestamp":1760950728000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.13361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,4]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1002\/mdc3.13361"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.13361","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,4]]},"assertion":[{"value":"2021-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}