{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:27:50Z","timestamp":1790116070995,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Dyskinesia is a debilitating complication of dopaminergic therapy in advanced Parkinson's disease.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To evaluate the effect of levodopa\u2010carbidopa intestinal gel (\n LCIG<\/jats:styled-content>\n ) on dyskinesia burden.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This is a post hoc analysis of the retrospective, observational\n \n CO<\/jats:bold>\n medication\n <\/jats:styled-content>\n S<\/jats:bold>\n tudy assessing\n M<\/jats:bold>\n ono\u2010 and\n \n c\n O<\/jats:bold>\n mbination\n <\/jats:styled-content>\n therapy with levodopa\u2010carbidopa\n \n inte\n S<\/jats:bold>\n tinal\n <\/jats:styled-content>\n gel (\n COSMOS<\/jats:styled-content>\n ;\n NCT03362879<\/jats:styled-content>\n ). Change in dyskinesia was assessed by\n LCIG<\/jats:styled-content>\n treatment group (monotherapy, daytime monotherapy, polytherapy), baseline dyskinesia duration (<4 vs. \u22654\u2009hours), and dyskinesia severity (troublesome vs. non\u2010troublesome). Correlations between changes in dyskinesia and patient\u2010reported outcomes (Parkinson's Disease Questionnaire\u20108 [\n PDQ<\/jats:styled-content>\n \u20108], Parkinson's Disease Sleep Scale\u20102 [\n PDSS<\/jats:styled-content>\n \u20102], non\u2010motor symptoms scale [\n NMSS<\/jats:styled-content>\n ]) were assessed using Spearman correlation coefficients. The Unified Parkinson's Disease Rating Scale\n IV<\/jats:styled-content>\n measured dyskinesia duration (Item 32), severity (Item 33), and pain (Item 34). Data were collected cross\u2010sectionally at a single study visit.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Over 50% (202\/369) of\n LCIG<\/jats:styled-content>\n \u2010treated patients experienced improvement in dyskinesia severity. Improvements in dyskinesia duration and severity were noted in all treatment groups. The proportion of patients with troublesome dyskinesia and amount of \u201cOff\u201d time significantly decreased from baseline to study visit, regardless of baseline dyskinesia burden (\n P<\/jats:italic>\n \u2009<\u20090.01); dyskinesia duration improved only in the \u22654\u2010hour subgroup (\n P<\/jats:italic>\n \u2009<\u20090.01). In the \u22654\u2010hour subgroup, dyskinesia duration correlated positively with\n PDQ<\/jats:styled-content>\n \u20108; dyskinesia severity correlated positively with\n PDQ<\/jats:styled-content>\n \u20108 and\n PDSS<\/jats:styled-content>\n \u20102; and dyskinesia pain correlated positively with\n PDQ<\/jats:styled-content>\n \u20108,\n PDSS<\/jats:styled-content>\n \u20102, and\n NMSS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n LCIG<\/jats:styled-content>\n led to reductions in dyskinesia severity, regardless of baseline dyskinesia burden. Dyskinesia duration improved in patients with high dyskinesia burden but not in those with low dyskinesia burden.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mdc3.70222","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T10:04:16Z","timestamp":1755252256000},"page":"98-107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Levodopa\u2010Carbidopa Intestinal Gel Improves Dyskinesia in Parkinson's Disease: Post Hoc Analysis from the\n COSMOS<\/scp>\n Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5346-0180","authenticated-orcid":false,"given":"Alfonso","family":"Fasano","sequence":"first","affiliation":[{"name":"Edmond J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, UHN, Division of Neurology University of Toronto Toronto ON Canada"},{"name":"Krembil Research Institute Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-6620","authenticated-orcid":false,"given":"Cleanthe","family":"Spanaki","sequence":"additional","affiliation":[{"name":"Neurology Department University General Hospital of Heraklion PA.G.N.I Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2092-9848","authenticated-orcid":false,"given":"Tanya","family":"Gurevich","sequence":"additional","affiliation":[{"name":"Movement Disorders Unit, Neurological Institute Tel Aviv Medical Center, Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9732-8947","authenticated-orcid":false,"given":"Robert","family":"Jech","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center of Clinical Neurosciences, First Faculty of Medicine Charles University in Prague, and General University Hospital in Prague Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6727-3802","authenticated-orcid":false,"given":"Per","family":"Svenningsson","sequence":"additional","affiliation":[{"name":"Section of Neurology, Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1675-036X","authenticated-orcid":false,"given":"J\u00f3zsef","family":"Sz\u00e1sz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine GE Palade University of Medicine, Pharmacy, Science and Technology of T\u00eergu Mure\u0219, and Emergency Clinical County Hospital Mure\u0219 T\u00eergu Mure\u0219 Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6663-395X","authenticated-orcid":false,"given":"Lydia","family":"Vela\u2010Desojo","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n Alcorc\u00f3n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9676-1282","authenticated-orcid":false,"given":"Mihaela","family":"Simu","sequence":"additional","affiliation":[{"name":"Department of Neurology Victor Babes University of Medicine and Pharmacy Timisoara Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Bergmann","sequence":"additional","affiliation":[{"name":"AbbVie Inc. 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