Evidence map›Paper›PMID 34018146›Full record

SynthesisAdvances in therapy2021

The Long-Term Impact of Levodopa/Carbidopa Intestinal Gel on 'Off'-time in Patients with Advanced Parkinson's Disease: A Systematic Review.

Angelo Antonini, Per Odin, Rajesh Pahwa, Jason Aldred, Ali Alobaidi, Yash J Jalundhwala, Pavnit Kukreja, Lars Bergmann, Sushmitha Inguva, Yanjun Bao and 1 more

Abstract readSystematic ReviewVideo-Audio Media
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Advances in therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Effects of levodopa/carbidopa intestinal gel infusion on autonomic symptoms in advanced Parkinson's disease: a systematic review.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025
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  11. Sustained efficacy and safety of levodopa-carbidopa intestinal gel in advanced Parkinson's disease: a 10-year observational study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Angelo AntoniniParkinson and Movement Disorders Unit, Center for Rare Neurological Diseases (ERN-RND), Department of Neurosciences, University of Padova, Padua, Italy. Angelo.antonini@unipd.it.
Per OdinDivision of Neurology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.
Rajesh PahwaDepartment of Neurology, University of Kansas Medical Center, Kansas City, USA.
Jason AldredSelkirk Neurology and Inland Northwest Neurological, Spokane, WA, USA.
Ali AlobaidiAbbVie Inc., North Chicago, USA.
Yash J JalundhwalaAbbVie Inc., North Chicago, USA.
Pavnit KukrejaAbbVie Inc., North Chicago, USA.
Lars BergmannAbbVie Inc., North Chicago, USA.
Sushmitha InguvaCenter for Pharmaceutical Marketing and Management, University of Mississippi, University, Oxford, USA.
Yanjun BaoAbbVie Inc., North Chicago, USA.
K Ray ChaudhuriKing's College London, and Parkinson's Foundation International Centre of Excellence, King's College Hospital, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLevodopa/carbidopa intestinal gel (LCIG; carbidopa/levodopa enteral suspension) has been widely used and studied for the treatment of motor fluctuations in levodopa-responsive patients with advanced Parkinson's disease (PD) when other treatments have not given satisfactory results. Reduction in 'off'-time is a common primary endpoint in studies of LCIG, and it is important to assess the durability of this response. This systematic literature review was conducted to qualitatively summarise the data on the long-term effects of LCIG therapy on 'off'-time.

methodsStudies were identified by searching PubMed, EMBASE and Ovid on 30 September 2019. Studies were included if they reported on patients with PD, had a sample size of ≥ 10, LCIG was an active intervention and 'off'-time was reported for ≥ 12 months after initiation of LCIG treatment. Randomised clinical trials, retrospective and prospective observational studies, and other interventional studies were included for selection. Data were collected on: 'off'-time (at pre-specified time periods and the end of follow-up), study characteristics, Unified Parkinson's Disease Rating Scale (UPDRS) II, III and IV total scores, dyskinesia duration, quality of life scores, non-motor symptoms and safety outcomes.

resultsTwenty-seven studies were included in this review. The improvement in 'off'-time observed shortly after initiating LCIG was maintained and was statistically significant at the end of follow-up in 24 of 27 studies. 'Off'-time was reduced from baseline to end of follow-up by 38-84% and was accompanied by a clinically meaningful improvement in quality of life. Stratified analysis of 'off'-time demonstrated mean relative reductions of 47-82% at 3-6 months and up to 83% reduction at 3-5 years of follow-up. Most studies reported significant improvements in activities of daily living and motor complications. Most frequent adverse events were related to the procedure or the device.

conclusionIn one of the largest qualitative syntheses of published LCIG studies, LCIG treatment was observed to provide a durable effect in reducing 'off'-time. INFOGRAPHIC: Video Abstract.

Indexed as

CarbidopaParkinson DiseaseActivities of Daily LivingAntiparkinson AgentsDrug CombinationsGelsHumansLevodopaObservational Studies as TopicQuality of LifeRetrospective StudiesAntiparkinson AgentsCarbidopaDrug CombinationsGelsLevodopaAdvanced Parkinson’s diseaseLCIGLong-term‘Off’-time

Identifiers

PMID34018146
PMCPMC8189983

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.