Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience
IntroductionParkinson’s disease (PD) is a progressive neurodegenerative disorder, in advanced stages characterized by motor and non-motor fluctuations, significantly impacting patients’ quality of life (QoL). Advanced therapies, such as levodopa/carbidopa intestinal gel or carbidopa/levodopa enteral...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1547557/full |
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| author | Igor Straka Zuzana Andre Zuzana Kosutzka Karin Gmitterova Karin Gmitterova Milos Stevove Zuzana Durkovicova Radovan Juricek Radovan Juricek Peter Valkovic Peter Valkovic Michal Minar |
| author_facet | Igor Straka Zuzana Andre Zuzana Kosutzka Karin Gmitterova Karin Gmitterova Milos Stevove Zuzana Durkovicova Radovan Juricek Radovan Juricek Peter Valkovic Peter Valkovic Michal Minar |
| author_sort | Igor Straka |
| collection | DOAJ |
| description | IntroductionParkinson’s disease (PD) is a progressive neurodegenerative disorder, in advanced stages characterized by motor and non-motor fluctuations, significantly impacting patients’ quality of life (QoL). Advanced therapies, such as levodopa/carbidopa intestinal gel or carbidopa/levodopa enteral suspension (LCIG/CLES) and levodopa/entacapone/carbidopa intestinal gel (LECIG), offer continuous levodopa administration to reduce fluctuations and improve QoL. However, these therapies require invasive percutaneous endoscopic gastrostomy with jejunal extension (PEG-J), which can lead to complications. This study aimed to analyze the incidence of complications related to gastrojejunostomy in patients treated with LCIG/CLES or LECIG and their impact on therapy outcomes.MethodsThis retrospective study included PD patients treated with LCIG/CLES or LECIG at our center over 15 years. Patients were included if they had a PEG-J inserted and had been on LCIG/CLES or LECIG for at least 3 months. Complications were analyzed to identify trends and practical solutions for management.ResultsOf 111 PEG-J insertions, we analyzed 106 patients treated with LCIG/CLES or LECIG. A total of 77.4% experienced at least one adverse event (AE), predominantly device-related (69.8%). Common complications included knotting (24.4%), disconnection (22.8%), and occlusion (17.1%) of the inner tube. Serious AEs were rare but included three deaths within 30 days post-procedure, severe skin phlegmon in two patients, and severe gastrointestinal discomfort in one patient. The duration of PEG-J significantly correlated with AEs.ConclusionGastrojejunostomy-related AEs in LCIG/CLES and LECIG therapies are common but generally manageable with proper intervention. Serious complications are rare, with less than 10% discontinuing treatment due to dissatisfaction. |
| format | Article |
| id | doaj-art-3daf80bcab1343bcb855c71ec77c0fb4 |
| institution | OA Journals |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-3daf80bcab1343bcb855c71ec77c0fb42025-08-20T02:31:19ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15475571547557Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experienceIgor Straka0Zuzana Andre1Zuzana Kosutzka2Karin Gmitterova3Karin Gmitterova4Milos Stevove5Zuzana Durkovicova6Radovan Juricek7Radovan Juricek8Peter Valkovic9Peter Valkovic10Michal Minar112nd Department of Neurology, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia2nd Department of Neurology, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia2nd Department of Neurology, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia2nd Department of Neurology, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, SlovakiaDepartment of Neurology, Slovak Medical University, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia3rd Department of Internal Medicine, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia3rd Department of Internal Medicine, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia3rd Department of Internal Medicine, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, SlovakiaDepartment of Gastroenterology, Hospital Bory, Bratislava, Slovakia2nd Department of Neurology, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, SlovakiaInstitute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia2nd Department of Neurology, Comenius University Bratislava, Faculty of Medicine, University Hospital Bratislava, Bratislava, SlovakiaIntroductionParkinson’s disease (PD) is a progressive neurodegenerative disorder, in advanced stages characterized by motor and non-motor fluctuations, significantly impacting patients’ quality of life (QoL). Advanced therapies, such as levodopa/carbidopa intestinal gel or carbidopa/levodopa enteral suspension (LCIG/CLES) and levodopa/entacapone/carbidopa intestinal gel (LECIG), offer continuous levodopa administration to reduce fluctuations and improve QoL. However, these therapies require invasive percutaneous endoscopic gastrostomy with jejunal extension (PEG-J), which can lead to complications. This study aimed to analyze the incidence of complications related to gastrojejunostomy in patients treated with LCIG/CLES or LECIG and their impact on therapy outcomes.MethodsThis retrospective study included PD patients treated with LCIG/CLES or LECIG at our center over 15 years. Patients were included if they had a PEG-J inserted and had been on LCIG/CLES or LECIG for at least 3 months. Complications were analyzed to identify trends and practical solutions for management.ResultsOf 111 PEG-J insertions, we analyzed 106 patients treated with LCIG/CLES or LECIG. A total of 77.4% experienced at least one adverse event (AE), predominantly device-related (69.8%). Common complications included knotting (24.4%), disconnection (22.8%), and occlusion (17.1%) of the inner tube. Serious AEs were rare but included three deaths within 30 days post-procedure, severe skin phlegmon in two patients, and severe gastrointestinal discomfort in one patient. The duration of PEG-J significantly correlated with AEs.ConclusionGastrojejunostomy-related AEs in LCIG/CLES and LECIG therapies are common but generally manageable with proper intervention. Serious complications are rare, with less than 10% discontinuing treatment due to dissatisfaction.https://www.frontiersin.org/articles/10.3389/fneur.2025.1547557/fulladvanced Parkinson’s diseaseadverse eventsgastrojejunostomylevodopa/carbidopa intestinal gel (LCIG)levodopa/entacapone/carbidopa intestinal gel (LECIG) |
| spellingShingle | Igor Straka Zuzana Andre Zuzana Kosutzka Karin Gmitterova Karin Gmitterova Milos Stevove Zuzana Durkovicova Radovan Juricek Radovan Juricek Peter Valkovic Peter Valkovic Michal Minar Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience Frontiers in Neurology advanced Parkinson’s disease adverse events gastrojejunostomy levodopa/carbidopa intestinal gel (LCIG) levodopa/entacapone/carbidopa intestinal gel (LECIG) |
| title | Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience |
| title_full | Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience |
| title_fullStr | Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience |
| title_full_unstemmed | Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience |
| title_short | Complications associated with intestinal infusion therapies in patients with Parkinson’s disease: a single-center retrospective study and 15-year experience |
| title_sort | complications associated with intestinal infusion therapies in patients with parkinson s disease a single center retrospective study and 15 year experience |
| topic | advanced Parkinson’s disease adverse events gastrojejunostomy levodopa/carbidopa intestinal gel (LCIG) levodopa/entacapone/carbidopa intestinal gel (LECIG) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1547557/full |
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