Evidence map›Paper›PMID 40814840›Full record

Observational studyMovement disorders clinical practice2026

Levodopa-Carbidopa Intestinal Gel Improves Dyskinesia in Parkinson's Disease: Post Hoc Analysis from the COSMOS Study.

Alfonso Fasano, Cleanthe Spanaki, Tanya Gurevich, Robert Jech, Per Svenningsson, József Szász, Lydia Vela-Desojo, Mihaela Simu, Lars Bergmann, Abdallah Saad and 2 more

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

Observational study in Movement disorders clinical practice, 2026. 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 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

12 authors.

Alfonso FasanoEdmond 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.ORCID https://orcid.org/0000-0001-5346-0180
Cleanthe SpanakiNeurology Department, University General Hospital of Heraklion PA.G.N.I, Heraklion, Greece.ORCID https://orcid.org/0000-0001-9824-6620
Tanya GurevichMovement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel.ORCID https://orcid.org/0000-0003-2092-9848
Robert JechDepartment of Neurology and Center of Clinical Neurosciences, First Faculty of Medicine, Charles University in Prague, and General University Hospital in Prague, Prague, Czech Republic.ORCID https://orcid.org/0000-0002-9732-8947
Per SvenningssonSection of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-6727-3802
József SzászFaculty of Medicine, GE Palade University of Medicine, Pharmacy, Science and Technology of Tîrgu Mureș, and Emergency Clinical County Hospital Mureș, Tîrgu Mureș, Romania.ORCID https://orcid.org/0000-0003-1675-036X
Lydia Vela-DesojoDepartment of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.ORCID https://orcid.org/0000-0001-6663-395X
Mihaela SimuDepartment of Neurology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.ORCID https://orcid.org/0000-0001-9676-1282
Lars BergmannAbbVie Inc., North Chicago, IL, USA.
Abdallah SaadAbbVie Inc., North Chicago, IL, USA.ORCID https://orcid.org/0000-0003-2968-463X
Juan Carlos ParraAbbVie Inc., North Chicago, IL, USA.ORCID https://orcid.org/0000-0002-5613-6121
Norbert KovácsDepartment of Neurology, Medical School, University of Pécs, Pécs, Hungary.ORCID https://orcid.org/0000-0002-7332-9240

Funding

AbbVie
6 · The paper itself

Abstract

backgroundDyskinesia is a debilitating complication of dopaminergic therapy in advanced Parkinson's disease.

objectivesTo evaluate the effect of levodopa-carbidopa intestinal gel (LCIG) on dyskinesia burden.

methodsThis is a post hoc analysis of the retrospective, observational COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS; NCT03362879). Change in dyskinesia was assessed by LCIG treatment group (monotherapy, daytime monotherapy, polytherapy), baseline dyskinesia duration (<4 vs. ≥4 hours), and dyskinesia severity (troublesome vs. non-troublesome). Correlations between changes in dyskinesia and patient-reported outcomes (Parkinson's Disease Questionnaire-8 [PDQ-8], Parkinson's Disease Sleep Scale-2 [PDSS-2], non-motor symptoms scale [NMSS]) were assessed using Spearman correlation coefficients. The Unified Parkinson's Disease Rating Scale IV measured dyskinesia duration (Item 32), severity (Item 33), and pain (Item 34). Data were collected cross-sectionally at a single study visit.

resultsOver 50% (202/369) of LCIG-treated 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 "Off" time significantly decreased from baseline to study visit, regardless of baseline dyskinesia burden (P < 0.01); dyskinesia duration improved only in the ≥4-hour subgroup (P < 0.01). In the ≥4-hour subgroup, dyskinesia duration correlated positively with PDQ-8; dyskinesia severity correlated positively with PDQ-8 and PDSS-2; and dyskinesia pain correlated positively with PDQ-8, PDSS-2, and NMSS.

conclusionLCIG 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.

Indexed as

Antiparkinson AgentsCarbidopaDyskinesia, Drug-InducedDyskinesiasLevodopaParkinson DiseaseAgedCross-Sectional StudiesDrug CombinationsFemaleGelsHumansMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexAntiparkinson AgentsCarbidopacarbidopa, levodopa drug combinationDrug CombinationsGelsLevodopadyskinesialevodopa‐carbidopa intestinal gelmonotherapyobservational studiesParkinson's disease

Identifiers

PMID40814840
PMCPMC12839488

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.