Evidence map›Paper›PMID 36802031›Full record

Observational studyJournal of neurology2023

Levodopa-carbidopa intestinal gel in advanced Parkinson's disease: long-term results from COSMOS.

Alfonso Fasano, Rocío García-Ramos, Tanya Gurevich, Robert Jech, Lars Bergmann, Olga Sanchez-Soliño, Juan Carlos Parra, Mihaela Simu

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03362879 (COSMOS - COmedication Study Assessing Mono- and cOmbination Therapy With Levodopa-carbidopa inteStinal Gel), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 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.

NCT03362879 completednot on this map

COSMOS - COmedication Study Assessing Mono- and cOmbination Therapy With Levodopa-carbidopa inteStinal Gel

TypeobservationalSponsorAbbVieRan2017 to 2018Enrolled412ConditionsParkinson's Disease (PD)
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. 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
    Pooled it
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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

8 authors.

Alfonso FasanoEdmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, Division of Neurology, University of Toronto, Toronto, ON, Canada. alfonso.fasano@uhn.ca.ORCID http://orcid.org/0000-0001-5346-0180
Rocío García-RamosMovement Disorders Unit, San Carlos Clinical Hospital, Complutense University of Madrid, Madrid, Spain.
Tanya GurevichMovement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv-Yafo, Israel.
Robert JechDepartment of Neurology and Center of Clinical Neurosciences, 1st Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Lars BergmannAbbVie Inc., North Chicago, IL, USA.
Olga Sanchez-SoliñoAbbVie Inc., North Chicago, IL, USA.
Juan Carlos ParraAbbVie Inc., North Chicago, IL, USA.
Mihaela SimuVictor Babes University of Medicine and Pharmacy, Timisoara, Romania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile immediate benefits of levodopa-carbidopa intestinal gel (LCIG) are evident in patients with Parkinson's disease (PD), long-term LCIG effects require further study.

objectivesWe explored long-term LCIG on motor symptoms, nonmotor symptoms (NMS), and LCIG treatment settings in patients with advanced PD (APD).

methodsData were obtained (medical records and patient visit) from COSMOS, a multinational, retrospective, cross-sectional post-marketing observational study in patients with APD. Patients were stratified into 5 groups based on LCIG treatment duration at the patient visit, from 1-2 to > 5 years LCIG. Between-group differences were assessed for changes from baseline in LCIG settings, motor symptoms, NMS, add-on medications, and safety.

resultsOut of 387 patients, the number of patients per LCIG group was: > 1- ≤ 2 years LCIG (n = 156); > 2- ≤ 3 years LCIG (n = 80); > 3- ≤ 4 years LCIG (n = 61); > 4- ≤ 5 years LCIG (n = 30); > 5 years LCIG (n = 60). Baseline values were similar; data reported are changes from the baseline. There were reductions in "off" time, dyskinesia duration, and severity across LCIG groups. Prevalence, severity, and frequency of many individual motor symptoms and some NMS were reduced amongst all LCIG groups, with few differences between groups. Doses for LCIG, LEDD and LEDD for add-on medications were similar across groups both at LCIG initiation and patient visit. Adverse events were similar across all LCIG groups and consistent with the established safety profile of LCIG.

conclusionsLCIG may provide sustained, long-term symptom control, while potentially avoiding increases in add-on medication dosages.

trial registrationClinicalTrials.gov Identifier: NCT03362879. Number and date: P16-831, November 30, 2017.

Indexed as

CarbidopaParkinson DiseaseAntiparkinson AgentsCross-Sectional StudiesDrug CombinationsGelsHumansLevodopaRetrospective StudiesAntiparkinson AgentsCarbidopaDrug CombinationsGelsLevodopaDyskinesiaLong-term treatmentMotor symptomsNonmotor symptomsParkinson's disease

Identifiers

PMID36802031
PMCPMC10130122

What OpenQuestion holds

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Registered trials

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.