Patient profile, indications, efficacy and safety of duodenal levodopa infusion in advanced Parkinson's disease


  • David Devos MD, PhD,

    Corresponding author
    1. Department of Neurology, EA2683 IFR114 IMPRT, CHU Lille, France
    • Service de Neurologie et Pathologie du Mouvement EA 2683, IFR 114, IMPRT, Hôpital R. Salengro, Clinique Neurologique, CHU de Lille, F-59037 LILLE cedex, France===

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  • for the French DUODOPA Study Group

  • Solvay Pharma only provided a logistic support for collecting CRF without financial compensation.

  • Potential conflict of interest: None.


The studies of duodenal infusion of a levodopa on small groups of parkinsonian patients have reported beneficial effects on motor complications. However, little is known about the patient profile and indications for duodenal levodopa infusion. The purpose of this study is to exhaustively investigate the clinical characteristics of the population and indication, efficacy and tolerability of duodenal levodopa infusion in natural care settings. Of the 102 patients treated with duodenal levodopa infusion since 2003, 91 were enrolled in a multicentre retrospective study. The mean age was 72.7 years, with average disease duration of 17 years. Patients were at advanced stage: 91% had gait disorders, 65% had visual hallucinations, and 50% were demented (MMSE: 23). Duodenal levodopa infusion was the last line of treatment for motor complications in 98% of the patients, due to failure of or contraindication for apomorphine pump and neurosurgical treatments. Long-term treatment was observed by 73% of the population. Of these, >90% reported an improvement in motor fluctuations, quality of life, and autonomy. There were few severe adverse events. Technical problems were commonplace. Duodenal levodopa infusion seems to be an effective last-line therapy for motor complications in Parkinson's disease. Hence, technical improvements and earlier introduction should be considered. © 2009 Movement Disorder Society.