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Observational Study
. 2021 Jun 25;21(1):242.
doi: 10.1186/s12883-021-02269-7.

The impact of tube replacement timing during LCIG therapy on PEG-J associated adverse events: a retrospective multicenter observational study

Kanefumi Yamashita  1 , Yukinori Yube  2 , Yukinao Yamazaki  3 , Takehide Fukuchi  4 , Masaki Kato  5 , Tomoyuki Koike  6 , Takeshi Uehara  7 , Yoshiou Ikeda  8 , Satoshi Furune  9 , Hidehiro Murakami  10 , Eiji Kubota  11 , Shinsuke Fujioka  12 , Yoshinori Sato  5 , Xiaoyi Jin  6 , Tomohiko Suzuki  9 , Kazuhiro Furukawa  9 , Yoshio Tsuboi  12
Affiliations
Observational Study

The impact of tube replacement timing during LCIG therapy on PEG-J associated adverse events: a retrospective multicenter observational study

Kanefumi Yamashita et al. BMC Neurol. .

Abstract

Background: Levodopa-carbidopa intestinal gel (LCIG) treatment, a unique drug delivery system for patients with advanced Parkinson's disease (PD), is covered by health insurance in Japan since September 2016. Various LCIG procedure/device-associated adverse events (AEs) have been reported; however, reports on their treatment have been limited. This is the first multicenter study to clarify the frequency and timing of device-related AEs.

Methods: Between September 2016 and December 2018, 104 patients introduced to the LCIG treatment for advanced PD in 11 hospitals were included. The patients' characteristics, AEs incidence, AEs time, and tube exchange time were investigated.

Results: The median follow-up period was 21.5 months. Minor AE cases were 29.4%, whereas major AE cases were 43.1%. Majority of major AEs (n = 55, 94.8%) were managed with endoscopic treatment, such as tube exchange. Few severe AEs required surgical treatment (n =3, 5.2%). The mean (range) exposure to percutaneous endoscopic gastrojejunostomy (PEG-J) was 14.7 (0-33) months. One year after the LCIG treatment introduction, 55 patients (54.0%) retained the original PEG-J tube. The mean PEG-J tube exchange time was 10.8 ± 7.0 months in all patients, 11.6 ± 4.7 and 10.5 ± 7.7 months in patients with scheduled exchange and who underwent exchange due to AEs, respectively.

Conclusions: Some device-related AEs occurred during the LCIG treatment; however, only few were serious, most of which could be treated with simple procedures or tube replacement with endoscopy. Therefore, the LCIG treatment is feasible and safe and is a unique treatment option for PD, requiring endoscopists' understanding and cooperation.

Keywords: Levodopa–carbidopa intestinal gel; Parkinson’s disease; Percutaneous endoscopic gastrojejunostomy.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Retention period of the original PEG-J tube (All PEG-J, N = 102). PEG-J = percutaneous endoscopic gastrojejunostomy, All PEG-J = dataset of patients who had PEG-J tube placement
See this image and copyright information in PMC

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