2026 American Academy of Neurology Abstract Website

Objective:

To evaluate the tolerability, patient-reported side effects and reasons for discontinuation of foslevodopa/foscarbidopa continuous subcutaneous infusion (LDp/CDp CSI) beyond the titration phase in a real-world cohort of people with Parkinson’s disease (PwP).

Background:

In clinical trials, LDp/CDp CSI significantly reduced motor fluctuations in Parkinson’s disease (PD). However, its tolerability in real-world clinical settings remains unclear. In the largest real-world case series to date (n=53), we previously reported a short-term discontinuation rate of 25% during inpatient titration.

Design/Methods:

A single-centre retrospective cross-sectional analysis.

Results:

LDp/CDp CSI was initiated in 69 PwP (38% female, aged 66.8±11.4 years, disease duration (DD) 14.3±5.7 years). Thirteen PwP (39% female, aged 65.4±13.8 years, DD 19.4±6.3 years) stopped the LDp/CDp CSI during the titration phase (after 15±7 days) due to the lack of efficacy (n=8), skin reactions (n=4), handling issues (n=2), and neuropsychiatric side effects (n=2). Thirty-seven PwP (38% female, aged 65.3±11 years, DD 13±5.3 years) were followed up for up to 82 weeks after the LDp/CDp initiation. Main complaints included dyskinesia (n=8), neuropsychiatric symptoms (n=8), gait difficulties (n=5), bradykinesia (n=4), OFF phases (n=1), troubles with the pump handling (n=2), dystonia (n=1), nausea (n=1) and/or lack of the effect (n=1). Eight PwP (50% female, aged 67.8±6.5 years, DD 11.8±5.7 years) discontinued the LDp/CDp CSI after 15 weeks (4-82 weeks) due to skin reactions (n=4), neuropsychiatric symptoms (n=2), handling issues (n=1), nausea (n=1), and/or lack of efficacy (n=1).

Conclusions:

LDp/CDp CSI appears to be an effective and generally well-tolerated non-surgical treatment option for managing motor fluctuations in PD. However, skin reactions and neuropsychiatric side effects warrant close monitoring during follow-up.