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TOPLINE
In patients with advanced Parkinson's disease (PD), 3 months of continuous subcutaneous foslevodopa-foscarbidopa infusion (CSFLI) was associated with significant alleviation of motor complications and non-motor fluctuations, especially during OFF state rather than ON state symptoms. Favourable changes were also observed in non-motor symptoms.
METHODOLOGY
- Researchers conducted a prospective, single-centre, real-world study to assess changes in motor complications, non-motor fluctuations, and non-motor symptoms among patients with advanced PD after switching from oral levodopa therapy to CSFLI over a 3-month period.
- The analysis included 40 patients (mean age, 67.05 years; 80% men) who initiated CSFLI between 2024 and 2026 and completed longitudinal follow-up for 3 months. The mean disease duration was 12.03 months.
- Motor complications, motor severity (in the OFF and ON states), and non-motor symptoms were assessed using standardised scales; non-motor fluctuations were evaluated with a dedicated standardised questionnaire.
- Researchers also assessed sleep, nocturnal and morning akinesia, depressive symptoms, autonomic symptoms, anxiety, fatigue, apathy, impulsive-compulsive behaviours, and quality of life using validated scales.
TAKEAWAY
- After 3 months of CSFLI treatment, motor complications were alleviated, with significant reductions in OFF time, ON time with dyskinesias, and disabling dyskinesias (false discovery rate [FDR]-adjusted P = .001 for all).
- CSFLI treatment was associated with a significant reduction in overall non-motor symptom burden, with significant favourable changes in the sleep or fatigue, mood or cognition, gastrointestinal, urinary, and miscellaneous domains (FDR-adjusted P = .001 for all).
- Non-motor fluctuations during OFF periods decreased significantly (FDR-adjusted P =.001), with favourable changes observed across the depression or anxiety, sleep or fatigue, and miscellaneous domains. Non-motor fluctuations during the ON state remained unchanged.
- Significant reductions or favourable changes were also observed in sleep-related symptoms, nocturnal and morning akinesia, depressive symptoms, and overall quality of life (FDR-adjusted P < .05 for all). No significant changes were noted in daytime sleepiness, anxiety, fatigue, apathy, autonomic symptoms, or impulsive-compulsive behaviours.
IN PRACTICE
"The present findings provide preliminary evidence that CSFLI may be associated with improvements in NMFs [non-motor fluctuations], particularly those occurring during the OFF state, while also highlighting the heterogeneous response of individual nonmotor domains and the importance of treatment tolerability and persistence," the authors wrote.
SOURCE
This study was led by Rosa De Micco, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. It was published online on October 26, 2026, in European Journal of Neurology.
LIMITATIONS
The observational design, small sample size, and lack of a control group prevented causal inferences. Because of the short follow-up period, the persistence of the observed effects over the long term could not be assessed. Treatment adjustments were performed based on individual clinical judgment.
DISCLOSURES
The study did not receive any specific funding. Two authors declared receiving honoraria for serving as speakers or consultants for multiple pharmaceutical companies.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
