Multicenter Retrospective Study of LCIG Therapy in Japan: Efficacy, Factors Associated with Discontinuation, and Case-based Insights
Abstract
Introduction Levodopa-carbidopa intestinal gel (LCIG) reduces the "off" time and improves the quality of life in people with Parkinson's disease (PwPD). However, real-world data from Asian populations, particularly Japan, are limited. Methods We retrospectively collected clinical data from PwPD who received LCIG across nine institutions in Kyushu, Japan. Patients who were assessed for key clinical parameters, including MDS-UPDRS Part III scores, Hoehn and Yahr (HY) stage, the daily "off" time, dyskinesia, and hallucinations, before LCIG initiation and at the latest available follow-up assessment at each participating institution were included in the study. The motor outcomes, daily "off" time, and neuropsychiatric complications were evaluated at baseline and at the latest available follow-up assessment. Statistical analyses were performed using the appropriate parametric and nonparametric tests. Results Thirty-seven PwPD were included based on the study criteria. LCIG therapy significantly reduced the MDS-UPDRS Part III scores (p=0.003) and HY stage during "off" states (p<0.001), as well as daily "off" time (p<0.001). No significant changes were observed during the "on" state. Compared with patients who continued LCIG, those who discontinued had significantly higher HY stages in the "on" state both before and after LCIG, and hallucinations were also significantly more frequent after LCIG initiation. Although no statistically significant differences were detected, PwPD who experienced tube-related complications were characterized by higher ages at disease onset and LCIG initiation and a greater HY stage during the "on" state following LCIG initiation. Conclusion This study provides region-specific real-world insights into LCIG therapy. Together with lessons from five instructive cases, these findings may help optimize LCIG management in clinical settings.
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BibTeX
@article{fujioka2026multicenter,
title = {{Multicenter Retrospective Study of LCIG Therapy in Japan: Efficacy, Factors Associated with Discontinuation, and Case-based Insights}},
author = {Shinsuke Fujioka and Takayasu Mishima and Yuki Yasutaka and Kotoe Inoue and Mari Watari and Yasushi Miyagi and Akihiro Hashiguchi and Ryuichi Okubo and Takashi Tokashiki and Kazuhito Tsuruta and Ryoichi Kurisaki and Dai Matsuse and Takenori Uozumi and Yoshio Tsuboi},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.7515-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7515-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Multicenter Retrospective Study of LCIG Therapy in Japan: Efficacy, Factors Associated with Discontinuation, and Case-based Insights
AU - Shinsuke Fujioka
AU - Takayasu Mishima
AU - Yuki Yasutaka
AU - Kotoe Inoue
AU - Mari Watari
AU - Yasushi Miyagi
AU - Akihiro Hashiguchi
AU - Ryuichi Okubo
AU - Takashi Tokashiki
AU - Kazuhito Tsuruta
AU - Ryoichi Kurisaki
AU - Dai Matsuse
AU - Takenori Uozumi
AU - Yoshio Tsuboi
PY - 2026
DA - 2026/08/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.7515-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7515-26/_article
AB - Introduction Levodopa-carbidopa intestinal gel (LCIG) reduces the "off" time and improves the quality of life in people with Parkinson's disease (PwPD). However, real-world data from Asian populations, particularly Japan, are limited. Methods We retrospectively collected clinical data from PwPD who received LCIG across nine institutions in Kyushu, Japan. Patients who were assessed for key clinical parameters, including MDS-UPDRS Part III scores, Hoehn and Yahr (HY) stage, the daily "off" time, dyskinesia, and hallucinations, before LCIG initiation and at the latest available follow-up assessment at each participating institution were included in the study. The motor outcomes, daily "off" time, and neuropsychiatric complications were evaluated at baseline and at the latest available follow-up assessment. Statistical analyses were performed using the appropriate parametric and nonparametric tests. Results Thirty-seven PwPD were included based on the study criteria. LCIG therapy significantly reduced the MDS-UPDRS Part III scores (p=0.003) and HY stage during "off" states (p<0.001), as well as daily "off" time (p<0.001). No significant changes were observed during the "on" state. Compared with patients who continued LCIG, those who discontinued had significantly higher HY stages in the "on" state both before and after LCIG, and hallucinations were also significantly more frequent after LCIG initiation. Although no statistically significant differences were detected, PwPD who experienced tube-related complications were characterized by higher ages at disease onset and LCIG initiation and a greater HY stage during the "on" state following LCIG initiation. Conclusion This study provides region-specific real-world insights into LCIG therapy. Together with lessons from five instructive cases, these findings may help optimize LCIG management in clinical settings.
SN - 1349-7235
SN - 0918-2918
ER -