Dopaminergic Infusion Therapies in Parkinson’s Disease: Real-World Data from a Portuguese Center
DOI:
https://doi.org/10.46531/sinapse/AO/160/2025Keywords:
Dopamine Agents / therapeutic use, Drug Administration Routes, Drug Combinations, Drug Delivery Systems, Levodopa, Parkinson Disease/drug therapy, Treatment OutcomeAbstract
Introduction: Levodopa remains the most effective therapy for Parkinson’s disease (PD). As the disease progresses and autonomic dysfunction develops, the absorption and response to oral treatments become compromised. In these stages, continuous infusion therapies can replace or complement oral treatments, allowing for more stable symptom control.
Methods: This was a retrospective observational study including PD patients who underwent infusion therapies at a tertiary hospital in northern Portugal between January 2022 and March 2025. Demographic data were collected, and the following scales were applied: Unified Parkinson’s Disease Rating Scale (UPDRS) parts III and IV; Non-Motor Symptoms Scale (NMSS); Parkinson’s Disease Questionnaire (PDQ-39); Parkinson’s Disease Sleep Scale-2 (PDSS-2); Mini Mental State Examination (MMSE); Hoehn and Yahr scale; and Patient Global Impression of Change (PGIC). Adverse events were also analyzed.
Results: Twenty-five patients were identified, predominantly male (71.4%), with a median age of 76 years (IQR 14). They had a mean disease duration of 13.6 ± 5.3 years and had experienced motor fluctuations for 6.7 ± 3.0 years. Fourteen patients were treated with subcutaneous foslevodopa/foscarbidopa (FCFLsc); eight with intestinal levodopa/carbidopa gel (LCGI); and three with subcutaneous apomorphine (SCA). There was a significant reduction in mean UPDRS III scores (from 61.1 to 47.8; p<0.001) and UPDRS IV scores (from 8.9 to 6.1; p=0.001) across the total sample, with the greatest impact observed in the FCFLsc subgroup. This subgroup also showed improvement in non-motor symptoms (NMSS, p=0.046) and sleep quality (PDSS-2, p=0.002). Adverse events were reported in 80% of patients, mostly related to the infusion site.
Conclusion: Infusion therapies proved effective in improving motor and non-motor symptoms and motor complications. Data regarding the FCFLsc pump, available in Portugal since 2024, provide relevant real-world insights, supporting its efficacy and safety in managing both motor and non-motor symptoms, including sleep quality.
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