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Review
. 2023;13(5):641-657.
doi: 10.3233/JPD-225112.

Infusion Therapies in the Treatment of Parkinson's Disease

Teus van Laar  1 , K Ray Chaudhuri  2   3 , Angelo Antonini  4 , Tove Henriksen  5 , Maja Trošt  6
Affiliations
Review

Infusion Therapies in the Treatment of Parkinson's Disease

Teus van Laar et al. J Parkinsons Dis. 2023.

Abstract

Oral levodopa is the gold-standard therapy for treating Parkinson's disease (PD) but after a few years of treatment the therapeutic window narrows, and patients often experience various treatment-related complications. Patients in this advanced PD stage may benefit from alternative therapy, such as continuous intrajejunal delivery of levodopa-carbidopa intestinal gel (LCIG; or carbidopa-levodopa enteral suspension), continuous intrajejunal delivery of levodopa-carbidopa-entacapone intestinal gel, or continuous subcutaneous apomorphine infusion. Consideration and initiation of infusion therapies in advanced PD are suggested before the onset of major disability. The present review summarizes clinical evidence for infusion therapy in advanced PD management, discusses available screening tools for advanced PD, and provides considerations around optimal use of infusion therapy.

Keywords: Continuous subcutaneous infusion; Parkinson’s disease; apomorphine; carbidopa; implantable infusion pumps; levodopa drug combination.

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Conflict of interest statement

Angelo Antonini has received compensation for consultancy and speaker-related activities from UCB, Boehringer Ingelheim, Ever Pharma, General Electric, Britannia, AbbVie, Kyowa Kirin, Zambon, Bial, Theravance Biopharma, Jazz Pharmaceuticals, Roche, and Medscape. He receives research support from Bial, Lundbeck, Roche, Angelini Pharmaceuticals, Horizon 2020 Grant 825785, Horizon 2020 Grant 101016902, Ministry of Education University and Research (MIUR) Grant ARS01_01081, Cariparo Foundation, and Movement Disorder Society for NMS Scale validation. He serves as a consultant for Boehringer Ingelheim for legal cases on pathologic gambling. He owns Patent WO2015110261-A1 and owns shares from PD Neurotechnology Limited.

K. Ray Chaudhuri is a study investigator and has served as an advisory board member for AbbVie, UCB, GKC, Bial, Cynapsus, Lobsor, Stada, Medtronic, Zambon, Profile, Sunovion, Roche, Therevance, Scion, Britannia, Acadia, and 4D. He received honoraria for lectures from AbbVie, Britannia, UCB, Zambon, Novartis, Boehringer Ingelheim, Bial, Kyowa Kirin, and SK Pharma. He has received grants (investigator initiated) from Britannia Pharmaceuticals, AbbVie, UCB, GKC, and Bial, and academic grants from EU, IMI EU, Horizon 2020, Parkinson’s UK, NIHR, PDNMG, EU (Horizon 2020), Kirby Laing Foundation, NPF, MRC, and Wellcome Trust. He receives royalties from Oxford University Press and holds intellectual property rights for the King’s Parkinson’s Pain Scale and Parkinson’s Disease Sleep Scale.

Tove Henriksen has received honorary for speaker related activities for AbbVie, Britannia, Convatec, Nordic Infucare, and Neuroderm. She is on a data monitoring committee for Lundbeck. She is Principal Investigator for an AbbVie sponsored study.

Maja Trošt has received research grants from the Slovenian Research Agency (J7-2600 and J7-3150), honorary for speaker related activities for AbbVie, STADA, and Britannia Pharmaceuticals Ltd., and consulting fees from STADA, AbbVie, and Guidepoint. She is on the advisory board of AbbVie and received financial support for attending meetings from AbbVie and Medtronic.

Teus van Laar has received research support from the Weston Brain Institute, the Michael J Fox Foundation, Parkinson NL, and the UMCG. He received speaker fees from Brittania, Genilac, Centrapharm, and AbbVie.

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