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LECIG for motor fluctuations in Parkinson’s disease

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Dag Nyholm, MD, PhD, Uppsala University, Uppsala, Sweden, discusses the use of the levodopa-entacapone-carbidopa intestinal gel (LECIG) for the treatment of motor fluctuations in Parkinson’s disease. The addition of entacapone, a COMT inhibitor, increases the bioavailability of levodopa, and therefore the doses of levodopa needed to be reduced. According to the pharmacokinetics studies, unchanged morning dose and 35% decrease of continuous flow rate, compared with levodopa-carbidopa intestinal gel doses, provided stable levodopa levels without accumulation. Prof. Nyholm outlines the suitable patient profile for LECIG and describes further studies planned to gain more knowledge on this intestinal gel formulation. This interview took place during the European Academy of Neurology 2021 congress.

The lessig is a new gel uh almost the same as as the the already marketed gel uh leave global in europe and or in many countries and and do over in the us um but this new gel uh also contains another ingredient which is anti-capone which is the compt inhibitor frequently used in oral tablets for for parkinson’s disease um so you could also call this new new pump

Treatment a floating salivo or something just to describe that it contains levodopa and the capone and carbidopa and it is an intestinal gel uh intended for pump infusion through a peg system with a jejunal tube just like the lcig system yeah we have used less sig the new pump uh here in sweden since uh two years ago when it was approved and also it’s available

In a few other european countries so far um it seems to work uh fine just uh as expected like like an ordinarily with open fusion works um there are of course some diff differences so the ingredient end capone is added to the gel now which makes well we have to decrease the level of dose by 25 to maybe 35 and according to our pharmacokinetic studies when we

Compare with the ordinary level of copyright intestinal we should keep the morning doses unchanged and then decrease the the infusion rates by 35 percent but then you have to fine-tune for for each individual as as usual the main difference for the patients is that the pump used is a different kind it’s much smaller and lighter and that’s something that all our

Patients have have been happy with the patient profile for for this kind of pump is the same as for deep brain stimulation uh leave it up uh carb dopa infusion and morphine infusion so any divisive treatments in parkinson’s disease um and then of course the treatment requires a peg surgery the same kind of peg system that is used with a with the older version

Of the liver dopa carbidopathy so otherwise i mean fluctuating patients with motor fluctuations dyskinesias that are in need of either very frequent levitopidosis orally or an advanced treatment like this further studies are planned of course there is a european project where sweden is not depart actually but other countries in europe are are planning a quite

Large register based study for for this new gel and also in sweden we have our national registry where we are collecting the so far around 100 patients i think on this treatment so far in sweden so i guess we will get much more information later on so far it’s only we have only published three articles on this mainly a pharmacokinetic study and then recently

This year an article on our first experience of our first 24 patients

Transcribed from video
LECIG for motor fluctuations in Parkinson's disease By VJNeurology