Sustained efficacy and safety of levodopa-carbidopa intestinal gel in advanced Parkinson's disease: a 10-year observational study.

Levodopa-Carbidopa Intestinal Gel (LCIG) provides continuous dopaminergic stimulation for patients with advanced Parkinson’s disease (aPD) and is particularly beneficial for those with disabling motor fluctuations unresponsive to oral therapies. This retrospective observational study evaluated the long-term outcomes of LCIG in 52 patients treated between 2010 and 2014, with up to 10 years of follow-up. At 10 years, 67% remained on therapy and 77% were alive. LCIG reduced “off” time by an average of 3.9 h/day at 1 year and sustained partial motor benefit over time. Treatment discontinuation and mortality were associated with cognitive decline and older age at initiation. Although LCIG dose requirements increased over time, the total dopaminergic load remained stable. Adverse events occurred in most patients but rarely led to treatment discontinuation. These findings suggest that LCIG offers sustained efficacy, high long-term treatment retention, and a manageable safety profile, supporting its role as a durable therapeutic option for carefully selected aPD patients.