June 4, 2012

Levodopa / Carbidopa Gel Pump: New Hope for People with Parkinson's?

Every so often, I see a new piece of information about Parkinson’s disease that really grabs my attention. This morning, it was an article published May 29 on the online site for the Parkinson’s Research Foundation about a 69-year-old PWP who has gotten significant relief from levodopa therapy delivered continuously by pump directly into his body. The device is called a Levodopa Carbidopa Intestinal Gel pump (LCIG). Available in Europe for about ten years, it is now being tested in the U.S.

Bob Van Housen has been living with PD for 12 years, and had gotten to the point where he was taking four pills every three hours just to control his symptoms. Occasionally, he needed even more. If Bob didn’t take his meds, he was unable to walk or drive.

Even when he was “maxed out” on pills, Bob’s wife Carol explained, he was spending about seven hours every day in an “off” condition – basically unable to function. Having been an active guy all his life, Bob was willing and eager to join the clinical trial at The Cleveland Clinic. There, he was fitted with a pump that could deliver the levodopa / carbidopa in gel form directly – and continuously -- into his small intestine through a kind of feeding tube.

According to clinic director Dr. Hubert Fernandez, “The small intestine is the largest area in our gastrointestinal system that absorbs the medication. The tube strategically ends there so that maximum absorption of the levodopa occurs.” The steady, uninterrupted administration of the drug releases the patient from the regular “on” and “off” periods that Parkinsonians experience with their pills.

The new pump therapy provides the same chemical effect on the brain as the pills do, just in a steady, more continuous way. The brain converts the levodopa into dopamine, which then facilities communication between brain and body. The carbidopa in the mix helps make sure the levodopa doesn’t get converted into dopamine BEFORE it reaches the brain. If it did, there’d be no therapeutic effect, since dopamine cannot pass the blood-brain barrier.

So far, Van Housen is very pleased with the results of the pump. "We can predict better how I'm going to feel and how I'm going to act,” he said. “So we can plan trips and work around those times when I otherwise would have been problematic." He calls his experience with the new therapy “life-changing,” and hopes the FDA will soon approve it, so others can enjoy the same quality of life improvements he has experienced.

In addition, while his old pills used to take up to 90 minutes to kick in, he feels the impact of the gel pump in about 20 minutes.

Here's a video of Janice Yelton, a Parkinsonian who received the gel pump last year. She gives a compelling testimonial that the new device has greatly improved her life:

Here’s the link to the story that first caught my attention: Parkinson's Research Foundation

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