ArticleMovement disorders clinical practice2025
Localization Matters: Impacts of PEG-J Localization in Intestinal Levodopa Therapy for Parkinson's Disease.
Article in Movement disorders clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Opicapone in Parkinson's Disease on Levodopa-Carbidopa Intestinal Gel Treatment: A Pilot, Randomized Study.Movement disorders clinical practice · 2025Trial
- Continuous infusion therapy after deep brain stimulation in Parkinson's disease: indications, outcomes, and patient selection.Journal of neural transmission (Vienna, Austria : 1996) · 2026Review
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Authors and funding
12 authors.
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Abstract
backgroundReal-world clinical evidence is missing to understand the resorption characteristics of levodopa through duodenal and jejunal parts of the small intestine.
objectiveTo characterize how different application sites of intestinal levodopa gel would impact on levodopa dosing and clinical outcomes.
methodsThis multicentre retrospective analysis investigated Parkinson's disease patients (n = 111) and their change in levodopa equivalent dosage when switching from oral treatment to intestinal continuous infusion therapy while stratifying for differences in percutaneous gastrojejunostomy (PEG-J) tube localizations. We analyzed data from patients treated with both levodopa-carbidopa (LCIG) and levodopa-carbidopa-entacapone (LECIG) intestinal gel.
resultsIn dichotomic analysis, duodenal and jejunal tube positions showed similar levodopa equivalent dosages changes from baseline (P = 0.143). This was similar when subdividing patients for LCIG and LECIG treatment. In duodenal PEG-J positions, 44.4% of patients showed persistent motor fluctuations compared to 21.9% in jejunal placements (P = 0.026). In duodenal positions, fluctuations most often persisted when the PEG-J tube was placed proximally into the duodenum. In jejunal localizations, several patients displayed a satisfactory outcome from the primary intervention but experienced dislocation of the PEG-J tube to a duodenal position. This was associated with re-emergence of motor fluctuations in a majority of them.
conclusionsOur real-world data suggest that LCIG and LECIG are absorbed similarly in both duodenal and jejunal portions of the small intestine. However, clinical data suggest, that jejunal positioning is critical to the stabilization of dopaminergic motor fluctuations.
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