{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:59:58Z","timestamp":1790650798239,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Introduction: The clinical outcome of switching to levodopa-entacapone-carbidopa intestinal gel (LECIG) after failure of subcutaneous foslevodopa\/foscarbidopa (fLD\/fCD) is unknown. We analyze it in people with Parkinson\u2019s disease (PwP) treated in Spain. Methods: Retrospective analysis of PwP who had previously received fLD\/fCD but dropped out for different reasons and started before this LECIG in Spain up to 30 November 2025. Non-parametric tests were applied to evaluate the changes between the pre- (Vpre) and post-treatment (Vpost) (LECIG) periods. Results: Data about 14 patients (57.1% males; 66.6 \u00b1 8.6 years old) from 12 hospitals out of a total of 15 who were treated with LECIG were included. The mean time with fLD\/fCD was 98.6 \u00b1 92.3 days, with 92.9% and 57.1% experiencing side effects and lack of response, respectively. Specifically, significant subcutaneous nodules were reported in up to 64.3% of the patients. LECIG was a direct switch from fLD\/fCD in 35.7% of the patients. LECIG was well tolerated, with only one dropout due to complications related to dementia. Adverse events were reported in 28.6% and 35.7% of the patients in the optimization and final follow-up evaluation (mean follow-up of 233.7 \u00b1 157.4 days) phases, respectively. From Vpre to Vpost, \u201cOff\u201d time was reduced in 2.9 \u00b1 1.9 h (p = 0.002) and motor symptoms burden improved significantly (p = 0.013), whereas a trend of significance was found for non-motor symptoms burden (p = 0.050) and quality of life (p = 0.126). Conclusions: LECIG could be an alternative therapeutic option in PwP who failed fLD\/fCD.<\/jats:p>","DOI":"10.3390\/brainsci16030343","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T11:59:36Z","timestamp":1774267176000},"page":"343","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcome of People with Parkinson\u2019s Disease Treated with Levodopa-Entacapone-Carbidopa Intestinal Gel Who Failed Previous Subcutaneous Foslevodopa\/Foscarbidopa"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-5111","authenticated-orcid":false,"given":"Diego","family":"Santos Garc\u00eda","sequence":"first","affiliation":[{"name":"Department of Neurology, Hospital Universitario de A Coru\u00f1a (HUAC), Complejo Hospitalario Universitario de A Coru\u00f1a (CHUAC), C\/As Xubias 84, 15006 A Coru\u00f1a, Spain"},{"name":"Grupo de Investigaci\u00f3n en Enfermedad de Parkinson y otros Trastornos del Movimiento, INIBIC (Instituto de Investigaci\u00f3n Biom\u00e9dica de A Coru\u00f1a), 15006 A Coru\u00f1a, Spain"},{"name":"Hospital San Rafael, 15006 A Coru\u00f1a, Spain"},{"name":"Fundaci\u00f3n Degen, 15004 A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00e9s","family":"Legarda","sequence":"additional","affiliation":[{"name":"Hospital Son Espases, 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara M.","family":"Gonz\u00e1lez Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Hospital del Bierzo, 24404 Ponferrada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Rodr\u00edguez Sanz","sequence":"additional","affiliation":[{"name":"Hospital Universitario La Paz, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabel","family":"Morales-Casado","sequence":"additional","affiliation":[{"name":"Complejo Hospitalario Universitario de Toledo, 45007 Toledo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Peral","sequence":"additional","affiliation":[{"name":"Hospital de Sant Joan Desp\u00ed Moises Broggi, 08970 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Caballol","sequence":"additional","affiliation":[{"name":"Hospital de Sant Joan Desp\u00ed Moises Broggi, 08970 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"\u00c1lvarez Sauco","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Elche, 03203 Elche, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5608-3874","authenticated-orcid":false,"given":"Iria","family":"Campos Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Hospital de Galdakao Usansolo, 48960 Galdakao, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9borah","family":"Alonso Modino","sequence":"additional","affiliation":[{"name":"Hospital Universitario N\u00aa S\u00aa de Candelaria, 38010 Santa Cruz de Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-4542","authenticated-orcid":false,"given":"Lydia","family":"L\u00f3pez Manzanares","sequence":"additional","affiliation":[{"name":"Hospital La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Olivares Romero","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Torrec\u00e1rdenas, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Blanco Ollero","sequence":"additional","affiliation":[{"name":"Hospital Universitario Juan Ram\u00f3n Jim\u00e9nez, 21005 Huelva, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1056\/NEJMra2401857","article-title":"Parkinson\u2019s Disease","volume":"391","author":"Tanner","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.parkreldis.2020.10.042","article-title":"Parkinson\u2019s disease advanced therapies\u2014A systematic review: More unanswered questions than guidance","volume":"83","author":"Marsili","year":"2021","journal-title":"Park. Relat. Disord."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s00702-024-02773-3","article-title":"Advanced therapies in Parkinson\u2019s disease: An individualized approach to their indication","volume":"131","author":"Sajonz","year":"2024","journal-title":"J. Neural Transm."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S1474-4422(22)00400-8","article-title":"Safety and efficacy of continuous subcutaneous foslevodopa-foscarbidopa in patients with advanced Parkinson\u2019s disease: A randomised, double-blind, active-controlled, phase 3 trial","volume":"21","author":"Soileau","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/mdc3.70239","article-title":"Profile of People with Parkinson\u2019s Disease Treated with a Device-Aided Therapy in Spain. A Comparative Multicenter Observational Study","volume":"13","author":"Solleiro","year":"2026","journal-title":"Mov. Disord. Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Santos-Garc\u00eda, D., Solleiro, \u00c1., Gonz\u00e1lez-Ortega, G., Mir, P., L\u00f3pez-Ariztegui, N., Legarda, I., Rojas-P\u00e9rez, M.E., Peral-Quir\u00f3s, A., Cabo, I., and Garc\u00eda-Ramos, R. (2025). Impact of device-aided therapies on quality of life in patients with Parkinson\u2019s disease. A comparative multicenter observational study. J. Neural Transm., epub ahead of print.","DOI":"10.21203\/rs.3.rs-7694482\/v1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s40263-025-01179-3","article-title":"Foslevodopa\/Foscarbidopa: A Review in Advanced Parkinson\u2019s Disease","volume":"39","author":"Blair","year":"2025","journal-title":"CNS Drugs"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1002\/mds.29410","article-title":"Levodopa Dose Equivalency in Parkinson\u2019s Disease: Updated Systematic Review and Proposals","volume":"38","author":"Jost","year":"2023","journal-title":"Mov. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e16535","DOI":"10.1111\/ene.16535","article-title":"Effectiveness and safety of levodopa-entacapone-carbidopa infusion in Parkinson disease: A real-world data study","volume":"32","author":"Muro","year":"2025","journal-title":"Eur. J. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Warnecke, T., Odin, P., Garc\u00eda-Ramos, R., Lopez, L., Tulb\u0103, D., Dan, T.F., Jianu, D.C., Ro\u017eankovi\u0107, P.B., and van Laar, T. (2025). Effects of levodopa-entacapone-carbidopa intrajejunal infusion on non-motor symptoms of advanced Parkinson\u2019s disease-interim analysis of the ELEGANCE study. J. Neural Transm., epub ahead of print.","DOI":"10.1007\/s00702-025-03033-8"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1002\/mdc3.70046","article-title":"Levodopa-Entacapone-Carbidopa Intrajejunal Infusion in Advanced Parkinson\u2019s Disease\u2014Interim Analysis of the ELEGANCE Study","volume":"12","author":"Weiss","year":"2025","journal-title":"Mov. Disord. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"107905","DOI":"10.1016\/j.parkreldis.2025.107905","article-title":"Continuous subcutaneous infusion therapies in Parkinson\u2019s disease: Evidence of efficacy and safety","volume":"139","author":"Katzenschlager","year":"2025","journal-title":"Park. Relat. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1007\/s40120-023-00533-1","article-title":"Continuous Subcutaneous Foslevodopa\/Foscarbidopa in Parkinson\u2019s Disease: Safety and Efficacy Results from a 12-Month, Single-Arm, Open-Label, Phase 3 Study","volume":"12","author":"Aldred","year":"2023","journal-title":"Neurol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1007\/s00702-023-02686-7","article-title":"Practical use of apomorphine infusion in Parkinson\u2019s disease: Lessons from the TOLEDO study and clinical experience","volume":"130","author":"Henriksen","year":"2023","journal-title":"J. Neural Transm."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1007\/s00702-023-02625-6","article-title":"Apprends-moi l\u2019art des petits pas: Levodopa, Carbidopa Intestinal Gel plus Entacapone","volume":"130","author":"Jost","year":"2023","journal-title":"J. Neural Transm."},{"key":"ref_16","first-page":"1","article-title":"Changes in Quality of Life in Parkinson\u2019s Disease: How Large Must They Be to Be Relevant?","volume":"48","author":"Aschermann","year":"2017","journal-title":"Neuroepidemiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"17562864221108018","DOI":"10.1177\/17562864221108018","article-title":"Levodopa-entacapone-carbidopa intestinal gel infusion in advanced Parkinson\u2019s disease: Real-world experience and practical guidance","volume":"15","author":"Nyholm","year":"2022","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/s40120-024-00635-4","article-title":"Subcutaneous Levodopa: A New Engine for the Vintage Molecule","volume":"13","author":"Batzu","year":"2024","journal-title":"Neurol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s00702-025-03006-x","article-title":"COMT inhibition with entacapone for patients with Parkinson\u2019s disease and motor complications: The novelty of continuous infusion","volume":"133","author":"Jenner","year":"2026","journal-title":"J. Neural Transm."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Szatm\u00e1ri, S., Sz\u00e1sz, J.A., Orb\u00e1n-Kis, K., Bar\u00f3ti, B., Bataga, S., Ciorba, M., Nagy, E.E., Neagoe, R.M., Mih\u00e1ly, I., and Sz\u00e1sz, P.Z. (2024). Levodopa-Entacapone-Carbidopa Intestinal Gel in the Treatment of Advanced Parkinson\u2019s Disease: A Single Center Real-World Experience. Pharmaceutics, 16.","DOI":"10.3390\/pharmaceutics16040453"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Georgiev, D., Delali\u0107, S., Zupan\u010di\u010d Kri\u017enar, N., Socher, A., Gurevich, T., and Tro\u0161t, M. (2022). Switching and Combining Device-Aided Therapies in Advanced Parkinson\u2019s Disease: A Double Centre Retrospective Study. Brain Sci., 12.","DOI":"10.20944\/preprints202202.0065.v1"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/3\/343\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T12:30:23Z","timestamp":1774269023000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/3\/343"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,22]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["brainsci16030343"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16030343","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,22]]}}}