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DOI: 10.1055/s-0042-104503
Praktische Anwendung der Levodopa-Pumpe
Practical Use of the Levodopa PumpPublication History
Publication Date:
29 July 2016 (online)
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Zusammenfassung
Patienten mit fortgeschrittenem Morbus Parkinson und motorischen Komplikationen unter einer optimierten oralen Therapie können deutlich von der kontinuierlichen intrajejunalen Levodopa/Carbidopa-Infusion mittels Medikamentenpumpe profitieren. Diese setzt jedoch eine korrekte Lage der JET-PEG-Sonde und eine fein justierte Einstellung der Pumpe voraus. Auch wenn das Verfahren in spezialisierten Zentren zur Routine gehört, gibt es bislang kein Standardvorgehen. Aus diesem Grund wurde eine Expertenempfehlung zur praktischen Anwendung der Levodopa-Pumpe entwickelt, um das Vorgehen zu vereinheitlichen und den Zugang der Patienten zu dieser Therapie zu erleichtern.
Abstract
Patients with advanced Parkinson’s disease and motor complications undergoing optimized oral therapy can significantly benefit from continuous intrajejunal levodopa/carbidopa infusion applied by means of a medication pump. However, this requires a correctly positioned PEG-J tube and finely adjusted pump settings. Although this method is a routine procedure in specialist centers, no standard procedure has been defined up to now. For this reason, an expert recommendation regarding the practical application has been developed in order to standardize the procedure and facilitate patient access to this treatment option.
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Literatur
- 1 Nyholm D, Askmark H, Gomes-Trolin C et al. Optimizing levodopa pharmacokinetics: intestinal infusion versus oral sustained-release tablets. Clin Neuropharmacol 2003; 26: 156-163
- 2 Marrinan S, Emmanuel AV, Burn DJ. Delayed gastric emptying in Parkinson’s disease. Mov Disord 2014; 29: 23-32
- 3 Olanow CW, Kieburtz K, Odin P et al. Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson’s disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol 2014; 13: 141-149
- 4 Slevin JT, Fernandez HH, Zadikoff C et al. Long-term safety and maintenance of efficacy of levodopa-carbidopa intestinal gel: an open-label extension of the double-blind pivotal study in advanced Parkinson’s disease patients. J Parkinsons Dis 2015; 5: 165-174
- 5 Fernandez HH, Standaert DG, Hauser RA et al. Levodopa-carbidopa intestinal gel in advanced Parkinson’s disease: final 12-month, open-label results. Mov Disord 2015; 30: 500-509
- 6 Antonini A, Yegin A, Preda C et al. Global long-term study on motor and non-motor symptoms and safety of levodopa-carbidopa intestinal gel in routine care of advanced Parkinson’s disease patients; 12-month interim outcomes. Parkinsonism Relat Disord 2015; 21: 231-235
- 7 Jost WH. Unwanted effects and interaction of intrajejunal levodopa/carbidopa administration. Expert Opin Drug Saf 2014; 13: 447-458
- 8 Müller T, van Laar T, Comblath DR et al. Peripheral neuropathy in Parkinson’s disease: levodopa exposure and implications for duodenal delivery. Parkinsonism Relat Disord 2013; 19: 501-507
- 9 Fachinformation Duodopa®, Stand Juli 2015.