Evidence map›Paper›PMID 38924339›Full record

Trial reportMovement disorders clinical practice2024

Motor Efficacy of Subcutaneous DIZ102, Intravenous DIZ101 or Intestinal Levodopa/Carbidopa Infusion.

Filip Bergquist, Mats Ehrnebo, Dag Nyholm, Anders Johansson, Fredrik Lundin, Per Odin, Per Svenningsson, Nil Dizdar, Elias Eriksson

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Movement disorders clinical practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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.

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

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

  1. Pooled it
  2. Review
  3. Observational
  4. Article
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

9 authors.

Filip BergquistDepartment of Pharmacology, University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-3437-0267
Mats EhrneboDepartment of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
Dag NyholmDepartment of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden.ORCID 0000-0001-9776-7715
Anders JohanssonDepartment of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden.
Fredrik LundinDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Per OdinDivision of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Per SvenningssonDepartment of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0001-6727-3802
Nil DizdarDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Elias ErikssonDepartment of Pharmacology, University of Gothenburg, Gothenburg, Sweden.

Funding

The Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement 73220; 77340Vetenskapsrådet 2014-07298
6 · The paper itself

Abstract

backgroundIt has been suggested that carbidopa at high blood concentrations may counter the therapeutic effect of levodopa in Parkinson's disease by entering the brain and blocking central levodopa conversion to dopamine. We previously demonstrated equivalent plasma levodopa concentration in patients with Parkinson's disease during 16 h of (1) intravenous carbidopa/levodopa (DIZ101) infusion, (2) subcutaneous carbidopa/levodopa (DIZ102) infusion or (3) intestinal carbidopa/levodopa gel infusion. Plasma levels of carbidopa were however approximately four times higher with DIZ101 and DIZ102 than with LCIG, and higher than those usually observed with oral levodopa/carbidopa.

objectivesTo investigate if high carbidopa blood concentrations obtained with parenteral levodopa/carbidopa (ratio 8:1) counter the effect of levodopa on motor symptoms.

methodsEighteen patients with advanced Parkinson's disease were administered DIZ101, DIZ102, and intestinal levodopa/carbidopa gel for 16 h on different days in randomized order. Video recordings of a subset of the motor examination in the Unified Parkinson's Disease Rating Scale (UPDRS) were evaluated by raters blinded for treatment and time. Motor function was also measured using a wrist-worn device monitoring bradykinesia, dyskinesia, and tremor (Parkinson KinetiGraph).

resultsThere was no tendency for poorer levodopa effect with DIZ101 or DIZ102 as compared to LCIG.

conclusionAlthough DIZ101 or DIZ102 causes approximately four times higher plasma carbidopa levels than LCIG, patients responded equally well to all treatments. The results do not indicate that high plasma carbidopa levels hamper the motor efficacy of levodopa.

Indexed as

Antiparkinson AgentsCarbidopaDrug CombinationsLevodopaParkinson DiseaseAgedFemaleHumansInfusions, IntravenousInfusions, SubcutaneousMaleMiddle AgedTreatment OutcomeAntiparkinson AgentsCarbidopacarbidopa, levodopa drug combinationDrug CombinationsLevodopacarbidopacontinuous subcutaneous infusionlevodopaParkinson's disease

Identifiers

PMID38924339
PMCPMC11452806

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Registered trials

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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.