# Outcome of People with Parkinson’s Disease Treated with Levodopa-Entacapone-Carbidopa Intestinal Gel Who Failed Previous Subcutaneous Foslevodopa/Foscarbidopa

## TL;DR

This study shows that switching to LECIG can improve motor symptoms and reduce 'Off' time in Parkinson's patients who did not respond well to fLD/fCD.

## Contribution

The first detailed description of outcomes for Parkinson's patients switching from fLD/fCD to LECIG.

## Key findings

- LECIG significantly reduced 'Off' time and improved motor symptoms in patients.
- There was a trend toward improved quality of life and non-motor symptoms.
- LECIG was well tolerated with only one patient dropping out due to dementia-related complications.

## Abstract

What are the main findings?
The reasons for the change and the outcome of patients treated with fLD/fCD who switched to LECIG are described in detail for the first time.The response to LECIG was favorable, with significant reduction of “Off” time and improvement in motor symptoms with a trend towards improvement in quality of life and NMS burden, as well as an adequate tolerability profile.

The reasons for the change and the outcome of patients treated with fLD/fCD who switched to LECIG are described in detail for the first time.

The response to LECIG was favorable, with significant reduction of “Off” time and improvement in motor symptoms with a trend towards improvement in quality of life and NMS burden, as well as an adequate tolerability profile.

What are the implications of the main findings?
LECIG could be an alternative therapeutic option in PwP who failed fLD/fCD.These findings reinforce the idea of the possibility of switching or associating DATs when the response to a previous DAT is not satisfactory.

LECIG could be an alternative therapeutic option in PwP who failed fLD/fCD.

These findings reinforce the idea of the possibility of switching or associating DATs when the response to a previous DAT is not satisfactory.

Introduction: The clinical outcome of switching to levodopa-entacapone-carbidopa intestinal gel (LECIG) after failure of subcutaneous foslevodopa/foscarbidopa (fLD/fCD) is unknown. We analyze it in people with Parkinson’s disease (PwP) treated in Spain. Methods: Retrospective analysis of PwP who had previously received fLD/fCD but dropped out for different reasons and started before this LECIG in Spain up to 30 November 2025. Non-parametric tests were applied to evaluate the changes between the pre- (Vpre) and post-treatment (Vpost) (LECIG) periods. Results: Data about 14 patients (57.1% males; 66.6 ± 8.6 years old) from 12 hospitals out of a total of 15 who were treated with LECIG were included. The mean time with fLD/fCD was 98.6 ± 92.3 days, with 92.9% and 57.1% experiencing side effects and lack of response, respectively. Specifically, significant subcutaneous nodules were reported in up to 64.3% of the patients. LECIG was a direct switch from fLD/fCD in 35.7% of the patients. LECIG was well tolerated, with only one dropout due to complications related to dementia. Adverse events were reported in 28.6% and 35.7% of the patients in the optimization and final follow-up evaluation (mean follow-up of 233.7 ± 157.4 days) phases, respectively. From Vpre to Vpost, “Off” time was reduced in 2.9 ± 1.9 h (p = 0.002) and motor symptoms burden improved significantly (p = 0.013), whereas a trend of significance was found for non-motor symptoms burden (p = 0.050) and quality of life (p = 0.126). Conclusions: LECIG could be an alternative therapeutic option in PwP who failed fLD/fCD.