View in EDS HTML Full Text PDF Full Text

Subcutaneous Levodopa in Parkinson's Disease: A Systematic Review and Meta‐Analysis.

Saved in:
Bibliographic Details
Title: Subcutaneous Levodopa in Parkinson's Disease: A Systematic Review and Meta‐Analysis.
Authors: Burton, Matthew (AUTHOR), Marsden, Duncan (AUTHOR), Harish, Dhruv (AUTHOR), Morris, Peter (AUTHOR), Heneghan, Carl (AUTHOR), Butler, Ailsa (AUTHOR), Nunan, David (AUTHOR)
Source: European Journal of Neurology. Feb2026, Vol. 33 Issue 2, p1-14. 14p.
Subjects: Subcutaneous infusions, Parkinson's disease, Quality of life, Dopa, Drug side effects
Abstract: Background: Many Parkinson's disease patients receiving oral levodopa/carbidopa experience a troublesome wearing off effect. Higher doses to mitigate OFF‐time are limited by adverse effects occurring at peak dopamine levels, particularly dyskinesia. A novel strategy to reduce OFF‐time without increasing peak dopamine levels is the continuous subcutaneous infusion of levodopa/carbidopa, or their prodrug equivalents foslevodopa/foscarbidopa. Objectives: Assess whether subcutaneous infusion therapies safely reduce OFF‐time and improve quality of life scores compared to oral levodopa/carbidopa. Methods: We searched MEDLINE, Embase, CENTRAL and ICTRP up to 28th October 2024 for clinical trials comparing subcutaneous infusions of levodopa or foslevodopa to oral levodopa in Parkinson's disease. Results: Screening of 1114 records identified seven studies in which 725 patients received subcutaneous infusion regimens of levodopa/carbidopa (ND0612) (407 patients) or foslevodopa/foscarbidopa (318 patients). Moderate quality evidence indicated subcutaneous infusion reduced the daily duration of OFF‐time by 1.98 h (p = 0.0004). Moderate quality evidence indicated improvements in health‐related quality of life score PDQ‐39 (p = 0.0003) and sleep score PDSS‐2 (p = 0.02), but an increase in the rate of treatment‐emergent adverse events, mostly related to the infusion site (p = 0.04). Conclusions: Subcutaneous infusion therapies produce a clinically and statistically significant reduction in the duration of OFF‐time experienced by patients with Parkinson's disease, compared to oral levodopa/carbidopa. Patient experience is improved by a statistically, but not clinically, significant degree. There are increased adverse events, mostly related to the infusion site. Overall, subcutaneous infusion regimens could provide a meaningful alternative for Parkinson's disease patients who experience severe motor fluctuations with existing levodopa formulations. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 192086911
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Subcutaneous Levodopa in Parkinson's Disease: A Systematic Review and Meta‐Analysis.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Burton%2C+Matthew%22">Burton, Matthew</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marsden%2C+Duncan%22">Marsden, Duncan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Harish%2C+Dhruv%22">Harish, Dhruv</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Morris%2C+Peter%22">Morris, Peter</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Heneghan%2C+Carl%22">Heneghan, Carl</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Butler%2C+Ailsa%22">Butler, Ailsa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nunan%2C+David%22">Nunan, David</searchLink> (AUTHOR)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2026, Vol. 33 Issue 2, p1-14. 14p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Subcutaneous+infusions%22">Subcutaneous infusions</searchLink><br /><searchLink fieldCode="DE" term="%22Parkinson's+disease%22">Parkinson's disease</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Dopa%22">Dopa</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+side+effects%22">Drug side effects</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Many Parkinson's disease patients receiving oral levodopa/carbidopa experience a troublesome wearing off effect. Higher doses to mitigate OFF‐time are limited by adverse effects occurring at peak dopamine levels, particularly dyskinesia. A novel strategy to reduce OFF‐time without increasing peak dopamine levels is the continuous subcutaneous infusion of levodopa/carbidopa, or their prodrug equivalents foslevodopa/foscarbidopa. Objectives: Assess whether subcutaneous infusion therapies safely reduce OFF‐time and improve quality of life scores compared to oral levodopa/carbidopa. Methods: We searched MEDLINE, Embase, CENTRAL and ICTRP up to 28th October 2024 for clinical trials comparing subcutaneous infusions of levodopa or foslevodopa to oral levodopa in Parkinson's disease. Results: Screening of 1114 records identified seven studies in which 725 patients received subcutaneous infusion regimens of levodopa/carbidopa (ND0612) (407 patients) or foslevodopa/foscarbidopa (318 patients). Moderate quality evidence indicated subcutaneous infusion reduced the daily duration of OFF‐time by 1.98 h (p = 0.0004). Moderate quality evidence indicated improvements in health‐related quality of life score PDQ‐39 (p = 0.0003) and sleep score PDSS‐2 (p = 0.02), but an increase in the rate of treatment‐emergent adverse events, mostly related to the infusion site (p = 0.04). Conclusions: Subcutaneous infusion therapies produce a clinically and statistically significant reduction in the duration of OFF‐time experienced by patients with Parkinson's disease, compared to oral levodopa/carbidopa. Patient experience is improved by a statistically, but not clinically, significant degree. There are increased adverse events, mostly related to the infusion site. Overall, subcutaneous infusion regimens could provide a meaningful alternative for Parkinson's disease patients who experience severe motor fluctuations with existing levodopa formulations. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=192086911
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/ene.70506
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 1
    Subjects:
      – SubjectFull: Subcutaneous infusions
        Type: general
      – SubjectFull: Parkinson's disease
        Type: general
      – SubjectFull: Quality of life
        Type: general
      – SubjectFull: Dopa
        Type: general
      – SubjectFull: Drug side effects
        Type: general
    Titles:
      – TitleFull: Subcutaneous Levodopa in Parkinson's Disease: A Systematic Review and Meta‐Analysis.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Burton, Matthew
      – PersonEntity:
          Name:
            NameFull: Marsden, Duncan
      – PersonEntity:
          Name:
            NameFull: Harish, Dhruv
      – PersonEntity:
          Name:
            NameFull: Morris, Peter
      – PersonEntity:
          Name:
            NameFull: Heneghan, Carl
      – PersonEntity:
          Name:
            NameFull: Butler, Ailsa
      – PersonEntity:
          Name:
            NameFull: Nunan, David
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 02
              Text: Feb2026
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 13515101
          Numbering:
            – Type: volume
              Value: 33
            – Type: issue
              Value: 2
          Titles:
            – TitleFull: European Journal of Neurology
              Type: main
ResultId 1