The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.


PHILADELPHIA — Individuals with advanced Parkinson disease have shown improved activities of daily living and quality of life with carbidopa/levodopa enteral suspension (CLES), which has demonstrated consistency across studies and through a 2-year follow-up period, according to research presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, 2019, in Philadelphia, Pennsylvania.

This pooled meta-analysis included 27 studies, 4 of which were clinical trials and 23 of which were observational, that included 1562 individuals with advanced Parkinson disease. These published trials and studies investigated the efficacy of CLES and were sourced from MEDLINE, EMBASE, Derwent Drug File, and BIOSIS Previews before September 8, 2017. The primary outcomes of interest in this analysis included activities of daily living (UPDRS-II) and quality of life (PDQ-8, PDQ-39, EQ-5D VAS, and EQ-5D). For each 3-month period from baseline to 2 years, a pooled mean change from baseline was estimated using a random-effects model while I2 and Q-statistic were used to assess heterogeneity.

There was statistically significant improvement among all outcomes of interest within a 3-month period of beginning CLES, with quality of life improvements maintained up to 2 years postinitiation (change from baseline in 10-12 months for PDQ-39: -8.6 [95% CI, -6.58 to -10.62]; change from baseline in 22-24 months for PDQ-39: -7.74 [95% CI, -3.07 to -12.40]).

Activities of daily living also showed improvement that was maintained up to the 2-year postinitiation point (change from baseline in 10-12 months for UPDRS-II OFF: -5.36 [95% CI, -2.03 to -8.70]; change from baseline in 22-24 months for UPDRS-II OFF: -3.88 [95% CI, -2.42 to -5.34]). These results did not change significantly when studies driving heterogeneity were excluded.

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The study researchers conclude that “CLES leads to improvement in [quality of life] and [activities of daily living] measures in [advanced Parkinson disease] patients that are consistent across a broad range of studies and persist for up to 2 years. Future analyses will evaluate correlation with other outcomes.”

Disclosure: Multiple authors disclosed affiliations with pharmaceutical companies. See the reference for complete disclosure information.

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Reference

Standaert D, Patel V, Snedecor S, et al. Impact of carbidopa-levodopa enteral suspension on quality of life and activities of daily living in patients with advanced Parkinson’s Disease: results from a pooled meta-analysis. Presented at: 2019 American Academy of Neurology Annual Meeting; May 4-10, 2019; Philadelphia, PA. Abstract P3.8-033.