Efficacy and Side-Effect Profile of Foslevodopa-Foscarbidopa Subcutaneous Infusion in Patients with Advanced Parkinson’s Disease: An Ambispective Longitudinal Study

BACKGROUND: Foslevodopa-foscarbidopa (LDp/CDp) is a soluble formulation of levodopa/carbidopa delivered as a continuous subcutaneous infusion for the treatment of motor fluctuations in people with Parkinson's disease. No real-world use data exist regarding its efficacy and safety from a high-volume Canadian center. METHODS: This is an ambispective longitudinal study (with the second visit at 1 month of enrollment) in patients with advanced Parkinson's disease from a tertiary care movement disorder center in Canada. OBJECTIVES: The primary objective of the study was to examine the efficacy of LDp/CDp in improving MDS UPDRS III scores, EURO-Q Index, EURO Q VAS score and ON time while reducing OFF time. Secondary objectives focused on safety. RESULTS: < 0.05) improvement in clinical efficacy parameters like the MDS UPDRS III (-11.37), OFF hours (-2.77), ON time without dyskinesias (+2.07), ON time with troublesome dyskinesias (-0.74 hours) and quality of life-related parameters like EURO Q Index (+0.10) and PDQ-39 (-10.78). One-fourth (26.5%) of the patients discontinued treatment, mostly due to infusion-site reactions or infections. CONCLUSION: LDp/CDp can be an effective treatment option for carefully selected patients with advanced Parkinson's disease and disabling motor complications. Appropriate hygiene measures may reduce the proportion of infusion site reactions, thereby improving patient retention on LDp/CDp infusion.