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A Study to Assess the Safety and Efficacy of Levodopa-carbidopa Intestinal Gel (LCIG) for the Treatment of Non-motor Symptoms in Patients With Advanced Parkinson's Disease

An Open-Label, Two Part, Multicenter Study to Assess the Safety and Efficacy of Levodopa-Carbidopa Intestinal Gel (LCIG) for the Treatment of Non-Motor Symptoms in Subjects With Advanced Parkinson's Disease

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01736176
Enrollment
39
Registered
2012-11-29
Start date
2013-03-31
Completion date
2015-12-31
Last updated
2021-07-16

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Advanced Parkinson's Disease

Keywords

Safety and efficacy, Advanced Parkinson's disease, levodopa-carbidopa intestinal gel,, carbidopa, levodopa, Non-Motor Symptom Scale

Brief summary

The primary objective of this study is to evaluate change in non-motor symptoms from baseline to Week 12 as measured by the Non-Motor Symptom Scale total score.

Interventions

Levodopa-carbidopa intestinal gel (LCIG) for upper-intestinal infusion is a suspension of levodopa (20 mg/mL) and carbidopa monohydrate (5 mg/mL) in an aqueous gel, administered continuously by a portable pump via a percutaneous endoscopic gastrojejunostomy (PEG-J) tube. The rate of LCIG infusion was expected to be within the range of 1 to 10 mL/hour (20 to 200 mg of levodopa/hour) in most instances over a period of 16 consecutive hours.

PROCEDUREPercutaneous Endoscopic Gastrostomy with Jejunal Extension (PEG-J)
DRUGLevodopa-carbidopa Immediate Release (LC-IR) Tablets

After LCIG initiation, participants could take prescribed oral levodopa-carbidopa immediate or continuous release (i.e., oral LC prescribed by the investigator) for nighttime use.

Sponsors

AbbVie (prior sponsor, Abbott)
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
30 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Subject must have a diagnosis of idiopathic Parkinson's disease (PD) according to the United Kingdom Parkinson's Disease Society (UKPDS) Brain Bank Criteria * Demonstrate persistent motor fluctuations in spite of individually optimized treatment * Subject must experience a minimum of 3 hours Off time

Exclusion criteria

* Subject's PD diagnosis is unclear or there is a suspicion that the subject has a Parkinsonian syndrome such as secondary Parkinsonism (e.g., caused by drugs, toxins, infectious agents, vascular disease, trauma, brain neoplasm), Parkinson-plus syndrome (e.g., Multiple System Atrophy, Progressive Supranuclear Palsy, Diffuse Lewy Body Disease, Corticobasilar Degeneration), or other neurodegenerative disease that might mimic the symptoms of PD. * Subject has undergone neurosurgery for the treatment of Parkinson's disease * Subject for whom the placement of a PEG-J tube for LCIG treatment is contraindicated or is considered a high risk for the PEG-J procedure according to the gastroenterology evaluation (e.g., pathological changes of the gastric wall, inability to bring the gastric wall and abdominal wall together, blood coagulation disorders, peritonitis, acute pancreatitis, paralytic ileus).

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline to Week 12 in the Non-Motor Symptom Scale (NMSS) Total ScoreBaseline and Week 12The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; the total score is obtained by summing the item scores. The NMSS total score ranges from 0 to 360 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Secondary

MeasureTime frameDescription
Change From Baseline in NMSS Urinary Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS urinary domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Sexual Function Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS sexual function domain score ranges from 0 to 24 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Miscellaneous Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS miscellaneous domain score ranges from 0 to 48 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in Mean Daily Normalized Off Time Based on Parkinson's Disease DiaryBaseline and Week 12 and Week 60The Parkinson's Disease Diary was completed by the participant for 3 consecutive days prior to each visit for the full 24 hours of each day. Participants recorded whether they had been On, Off, or Asleep and the severity of their dyskinesias (troublesome or not troublesome) for each 30-minute period during their normal waking time and upon awakening from time asleep. Off time was defined as time when medication has worn off and was no longer providing benefit with regard to mobility, slowness, and stiffness. Parkinson's Disease Diary times were normalized to a 16-hour waking time to account for variation in participants' sleep time. Normalized PD Diary times at a given visit were calculated as the average normalized time from the PD Diary for the 3 days prior to the visit.
Change From Baseline in Mean Daily Normalized On Time Without Troublesome Dyskinesia Based on PD DiaryBaseline and Week 12 and Week 60The PD Diary was completed by the participant for 3 consecutive days prior to each visit. Participants recorded whether they had been On, Off, or Asleep and the severity of their dyskinesias (troublesome or not troublesome) for each 30-minute period during their normal waking time and upon awakening from sleep. On was defined as time when medication was providing benefit with regard to mobility, slowness, and stiffness. On time without troublesome dyskinesia is a composite of On time without dyskinesia (involuntary twisting, turning movements which are an effect of medication) plus On time with non-troublesome dyskinesia (dyskinesia that does not interfere with function or cause meaningful discomfort). PD Diary times were normalized to a 16-hour waking time to account for variation in participants' sleep time. Normalized PD Diary times at a given visit were calculated as the average normalized time from the PD Diary for the 3 days prior to the visit.
Change From Baseline for Unified Parkinson's Disease Rating Scale (UPDRS) Total ScoreBaseline and Week 12 and Week 60The Unified Parkinson's Disease Rating Scale (UPDRS) is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The Total UPDRS score includes 31 items contributing to three subscales: (I) Mentation, Behavior, and Mood; (II) Activities of Daily Living; and (III) Motor Examination. Each question is answered on a scale from 0 (None) to 4 (Severe); Some questions require multiple grades assigned to each extremity. The UPDRS Total score was computed as the sum of these 3 UPDRS subscales and ranged from 0 to 176, with 176 representing the worst (total) disability, and 0 no disability.
Change From Baseline in UPDRS Part I: Mentation, Behavior, and Mood ScoreBaseline and Week 12 and Week 60The Unified Parkinson's Disease Rating Scale (UPDRS) is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The mentation, behavior, and mood score includes 4 items addressing intellectual impairment, thought disorder, motivation/initiative, and depression. Each question is answered on a scale from 0 (None) to 4 (Severe). The UPDRS Part I: mentation, behavior, and mood score was computed as the sum of these items and ranged from 0 (not affected) to 16 (most severely affected).
Change From Baseline in UPDRS Part II: Activities of Daily Living (ADL) ScoreBaseline and Week 12 and Week 60The Unified Parkinson's Disease Rating Scale (UPDRS) is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The activities of daily living score includes 13 items addressing speech, salivation, swallowing, handwriting, cutting food, dressing, hygiene, turning in bed, falling, freezing, walking, tremor, and sensory complaints. Each question is answered on a scale from 0 (Normal) to 4 (Severe). The UPDRS Part II: activities of daily living score was computed as the sum of these items and ranged from 0 (not affected) to 52 (most severely affected).
Change From Baseline in UPDRS Part III: Motor Examination ScoreBaseline and Week 12 and Week 60The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The motor examination score includes 17 items addressing speech, facial expression, tremor at rest, action tremor, rigidity, finger taps, hand movements, hand pronation and supination, leg agility, arising from chair, posture, gait, postural stability, and body bradykinesia. Each question is answered on a scale from 0 (Normal) to 4 (Severe), some items include multiple grades for each extremity. The UPDRS Part III: motor examination score was computed as the sum of these items and ranged from 0 (not affected) to 108 (most severely affected).
Number of Participants Who Used Healthcare Resources During the First 4 WeeksWeeks 1-4Use of healthcare resources was assessed by the investigator using the Health Resource Utilization Questionnaire (HRUQ), a questionnaire developed by the Sponsor regarding the use of healthcare resources due to the participant's Parkinson's disease. The Week 4 version of the questionnaire addressed the following questions during the first four weeks after the PEG-J procedure: 1. Has the subject had a visit to an emergency room? 2. Has the subject had a visit to an urgent care? 3. Has the subject had an outpatient visit to a neurologist? 4. Has the subject had an outpatient visit to a gastroenterologist, surgeon, or interventional radiologist? 5. Has the subject had an outpatient visit to a primary care physician? 6. Has the subject called the nursing support line? 7. Has the subject called a physician?
Number of Participants With Adverse EventsWeeks 1-4 and Overall (from Week 1 through 30 days after the end of the LCIG Treatment Period; median duration of LCIG device exposure was 428 days)Adverse events (AEs) related to treatment are those the investigator determined as having a reasonable possibility being related to study drug based on evidence to suggest a causal relationship between the study drug and the adverse event. A severe AE was defined as an adverse event that caused considerable interference with the participant's usual activities and might be incapacitating or life-threatening. Serious AEs were defined as those that were life-threatening or resulted in death, hospitalization or prolongation of hospitalization, a congenital anomaly, persistent or significant disability/incapacity, or important medical events requiring medical or surgical intervention to prevent a serious outcome.
Number of Participants Who Used Healthcare Resources Through Week 60Week 60Use of healthcare resources was assessed by the investigator using the Health Resource Utilization Questionnaire (HRUQ), a questionnaire developed by the Sponsor regarding the use of healthcare resources due to the participant's Parkinson's disease. The standard version of the questionnaire addressed the following questions over the last 3 months: 1. Has the subject had a visit to an emergency room? 2. Has the subject had an outpatient visit to any of the following healthcare providers? 3. Has the subject been visited in his or her place of residence by a health care professional? 4. Has the subject received assistance from either of the following for their Parkinson's disease in their home? 5. Has the subject needed to contact either of the following for immediate assistance related to their Parkinson's disease? 6. Have family members or friends had to miss any paid work due to the subject's Parkinson's disease? 7. Has the subject fallen during the past month?
Change From Baseline to Week 60 in the Non-Motor Symptom Scale (NMSS) Total ScoreBaseline and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; the total score is obtained by summing the item scores. The NMSS total score ranges from 0 to 360 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Cardiovascular Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS cardiovascular including falls domain score ranges from 0 to 24 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Sleep/Fatigue Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS sleep/fatigue domain score ranges from 0 to 48 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Mood/Cognition Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS mood/cognition domain score ranges from 0 to 72 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Perceptual Problems/Hallucinations Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS perceptual problems/hallucinations domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Attention/Memory Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS attention/memory domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in NMSS Gastrointestinal Tract Domain ScoreBaseline and Week 12 and Week 60The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS gastrointestinal tract domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.
Change From Baseline in UPDRS Dyskinesia Items ScoreBaseline and Week 12 and Week 60The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The dyskinesia items score includes questions 32, 33 and 34 from the complications of therapy section of the UPDRS which address dyskinesia duration, disability, and pain. Each question was answered on a scale from 0 (Normal) to 4 (Severe); the UPDRS dyskinesia items score was computed as the sum of these items and ranged from 0 (not affected) to 12 (most severely affected).
Change From Baseline in UPDRS Part V: Modified Hoehn and Yahr Staging ScoreBaseline and Week 12 and Week 60The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The modified Hoehn and Yahr scale is as follows: * Stage 0: No signs of disease * Stage 1.0: Symptoms are very mild; unilateral involvement only * Stage 1.5: Unilateral and axial involvement * Stage 2: Bilateral involvement without impairment of balance * Stage 2.5: Mild bilateral disease with recovery on pull test * Stage 3: Mild to moderate bilateral disease; some postural instability; physically independent * Stage 4: Severe disability; still able to walk or stand unassisted * Stage 5: Wheelchair bound or bedridden unless aided
Change From Baseline in Parkinson's Disease Questionnaire-39 Item (PDQ-39) Summary IndexBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). The PDQ-39 Summary Index (PDQ-SI) is the sum of all answers divided by the highest score possible (i.e., number of answers multiplied by 4) which is multiplied by 100 to put the score on a 0 - 100 scale where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Mobility Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Activities of Daily Living Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Emotional Well-Being Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Stigma Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Social Support Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Cognition Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Communication Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Change From Baseline in PDQ-39 Bodily Discomfort Domain ScoreBaseline and Week 12 and Week 60The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.
Percentage of Participants With a Patient Global Impression of Change (PGIC) Response of ImprovedWeek 12 and Week 60The PGIC is a 7-point response scale. Participants were asked to rate their change in status using the following 7-point scale: 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. The responses of Very much improved, Much improved and Minimally improved on the PGIC were used to define responders.
Treatment Satisfaction Questionnaire ScoresWeek 12 and Week 60The Treatment Satisfaction Questionnaire (TSQ) is a single item instrument developed by the Sponsor on which the participant indicated their level of satisfaction or dissatisfaction with their PD treatment. The responses are recorded on a Likert-type scale (Very Satisfied, Satisfied, Somewhat Satisfied, Somewhat Dissatisfied, Dissatisfied, Very Dissatisfied).
Change From Baseline in Health-related ProductivityBaseline, Week 12 and Week 60The Health-Related Productivity Questionnaire (HRPQ) is a generic measure of the impact of disease on the ability of the participant to be productive at paid employment or at performance of household chores. Questions inquire about the amount of time they were scheduled/planned to work, the number of the scheduled/planned hours they were able to work and their ability to be productive for the hours of work they did perform. Absenteeism: Number of hours not worked due to PD or it's treatments; Presenteeism: Number of hours of lost productivity while at work due to PD or it's treatments; Total hours lost: Number of hours lost due to absenteeism and presenteeism
Change From Baseline in Cambridge Neuropsychological Test Automated Battery (CANTAB) Spatial Working Memory Between Errors Score at Week 12Baseline and Week 12CANTAB is a computer-based test of the participant's ability to retain spatial information and to manipulate remembered items in working memory. The Spatial Working Memory module requires that subjects find a blue token in a series of displayed boxes and use these to fill up an empty column, while not returning to boxes where a blue token has been previously found. The between errors score is the number of times the participant revisited a box in which a token was previously found; errors are calculated for 4-, 6-, and 8-box trials. Higher numbers indicate poorer performance.
Change From Baseline in CANTAB Spatial Working Memory Strategy Score at Week 12Baseline and Week 12CANTAB is a computer-based test of the participant's ability to retain spatial information and to manipulate remembered items in working memory. The Spatial Working Memory module requires that subjects find a blue token in a series of displayed boxes and use these to fill up an empty column, while not returning to boxes where a blue token has been previously found. The Strategy score represents the number of times a participant begins a search with the same box for 6- and 8-box problems. Minimum score is 8 and maximum score is 56. Higher numbers indicate poorer performance.
Change From Baseline in Controlled Oral Word Association Test (COWAT) Verbal Fluency Scores at Week 60Baseline and Week 60Letter fluency was assessed using a paper and pen test, in which participants were asked to generate as many words as possible in 60 seconds, starting with the letters F, A, or S. The COWAT All Letters score is the number of words recalled in all post-baseline assessments, regardless of letter used. The COWAT Baseline Letter score is the number of words recalled in post-baseline assessments that used the same letter as at Baseline.
Change From Baseline in UPDRS Part IV: Complications of Therapy ScoreBaseline and Week 12 and Week 60The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The complications of therapy section includes 11 items addressing dyskinesia duration, disability, and pain, early morning dystonia, offs-predictable, offs-unpredictable, offs-sudden, offs-duration, anorexia-nausea-vomiting, sleep disturbance, and symptomatic orthostasis. Four questions are answered on a scale from 0 (Normal) to 4 (Severe) and seven on a binary scale where 0=No and 1=Yes. The UPDRS Part IV: complications of therapy score was computed as the sum of these items and ranged from 0 (not affected) to 23 (most severely affected).

Participant flow

Recruitment details

This study was conducted at 12 sites in the United States that specialized in movement disorders. Participants were levodopa-responsive with advanced Parkinson's disease (PD) and persistent motor fluctuations despite attempts to optimize treatment with oral levodopa-carbidopa and other available anti-PD medications.

Pre-assignment details

During screening participants converted their current daytime levodopa-carbidopa doses to oral levodopa-carbidopa 100/25 mg immediate release (LC-IR); other anti-PD medications could be continued, reduced or discontinued at the investigator's discretion. LC-IR and all other anti-PD treatments were discontinued at LCIG initiation.

Participants by arm

ArmCount
Levodopa-Carbidopa Intestinal Gel
Participants had a PEG-J tube placement procedure performed on Day 1 and, at the discretion of the investigator, began initiation and titration of LCIG infusion. Dosing was determined individually and was adjusted to obtain the optimal clinical response for each participant. Participants received treatment for up to 60 weeks or until LCIG was commercially available.
39
Total39

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event3
Overall StudyLack of Efficacy3
Overall StudyUnable to Complete PEG Placement1
Overall StudyWithdrawal by Subject4

Baseline characteristics

CharacteristicLevodopa-Carbidopa Intestinal Gel
Age, Continuous64.3 years
STANDARD_DEVIATION 10.23
Age, Customized
< 65 years
17 Participants
Age, Customized
≥ 65 years
22 Participants
Duration of PD11.5 years
STANDARD_DEVIATION 5.34
Non-Motor Symptoms Scale (NMSS) Total Score48.3 units on a scale
STANDARD_DEVIATION 35.63
PD Symptoms Present
Bradykinesia
37 Participants
PD Symptoms Present
Muscular rigidity
33 Participants
PD Symptoms Present
Postural instability
22 Participants
PD Symptoms Present
Resting tremor
25 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
Race/Ethnicity, Customized
Asian
2 Participants
Race/Ethnicity, Customized
Black or African American
1 Participants
Race/Ethnicity, Customized
Hispanic or Latino
2 Participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
0 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino
37 Participants
Race/Ethnicity, Customized
White
36 Participants
Sex: Female, Male
Female
16 Participants
Sex: Female, Male
Male
23 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
36 / 39
serious
Total, serious adverse events
8 / 39

Outcome results

Primary

Change From Baseline to Week 12 in the Non-Motor Symptom Scale (NMSS) Total Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; the total score is obtained by summing the item scores. The NMSS total score ranges from 0 to 360 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12

Population: The Efficacy dataset included all participants who received at least 1 infusion of LCIG study drug and had a baseline and LCIG Treatment Period observation for at least one efficacy or health outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline to Week 12 in the Non-Motor Symptom Scale (NMSS) Total Score-17.6 units on a scaleStandard Error 3.6
Comparison: The primary null hypothesis was no change in least-square (LS) mean, calculated using a mixed-effect repeated measures model (MMRM), for NMSS total score from baseline to Week 12. The statistical test was two-sided and the null hypothesis was rejected at the significance level of α = 0.050.p-value: <0.001Mixed-effect Repeated Measures (MMRM)
Secondary

Change From Baseline for Unified Parkinson's Disease Rating Scale (UPDRS) Total Score

The Unified Parkinson's Disease Rating Scale (UPDRS) is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The Total UPDRS score includes 31 items contributing to three subscales: (I) Mentation, Behavior, and Mood; (II) Activities of Daily Living; and (III) Motor Examination. Each question is answered on a scale from 0 (None) to 4 (Severe); Some questions require multiple grades assigned to each extremity. The UPDRS Total score was computed as the sum of these 3 UPDRS subscales and ranged from 0 to 176, with 176 representing the worst (total) disability, and 0 no disability.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at baseline (37) and each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline for Unified Parkinson's Disease Rating Scale (UPDRS) Total ScoreWeek 12-11.4 units on a scaleStandard Error 1.67
Levodopa-Carbidopa Intestinal GelChange From Baseline for Unified Parkinson's Disease Rating Scale (UPDRS) Total ScoreWeek 60-7.7 units on a scaleStandard Error 2.26
Secondary

Change From Baseline in Cambridge Neuropsychological Test Automated Battery (CANTAB) Spatial Working Memory Between Errors Score at Week 12

CANTAB is a computer-based test of the participant's ability to retain spatial information and to manipulate remembered items in working memory. The Spatial Working Memory module requires that subjects find a blue token in a series of displayed boxes and use these to fill up an empty column, while not returning to boxes where a blue token has been previously found. The between errors score is the number of times the participant revisited a box in which a token was previously found; errors are calculated for 4-, 6-, and 8-box trials. Higher numbers indicate poorer performance.

Time frame: Baseline and Week 12

Population: Efficacy dataset with available data

ArmMeasureValue (MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in Cambridge Neuropsychological Test Automated Battery (CANTAB) Spatial Working Memory Between Errors Score at Week 12-0.6 errorsStandard Deviation 7.73
Secondary

Change From Baseline in CANTAB Spatial Working Memory Strategy Score at Week 12

CANTAB is a computer-based test of the participant's ability to retain spatial information and to manipulate remembered items in working memory. The Spatial Working Memory module requires that subjects find a blue token in a series of displayed boxes and use these to fill up an empty column, while not returning to boxes where a blue token has been previously found. The Strategy score represents the number of times a participant begins a search with the same box for 6- and 8-box problems. Minimum score is 8 and maximum score is 56. Higher numbers indicate poorer performance.

Time frame: Baseline and Week 12

Population: Efficacy dataset with available data

ArmMeasureValue (MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in CANTAB Spatial Working Memory Strategy Score at Week 120.8 units on a scaleStandard Deviation 2.31
Secondary

Change From Baseline in Controlled Oral Word Association Test (COWAT) Verbal Fluency Scores at Week 60

Letter fluency was assessed using a paper and pen test, in which participants were asked to generate as many words as possible in 60 seconds, starting with the letters F, A, or S. The COWAT All Letters score is the number of words recalled in all post-baseline assessments, regardless of letter used. The COWAT Baseline Letter score is the number of words recalled in post-baseline assessments that used the same letter as at Baseline.

Time frame: Baseline and Week 60

Population: Efficacy dataset with available data

ArmMeasureGroupValue (MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in Controlled Oral Word Association Test (COWAT) Verbal Fluency Scores at Week 60All Letters Score-0.5 wordsStandard Deviation 4.8
Levodopa-Carbidopa Intestinal GelChange From Baseline in Controlled Oral Word Association Test (COWAT) Verbal Fluency Scores at Week 60Baseline Letter Score-1.8 wordsStandard Deviation 4.03
Secondary

Change From Baseline in Health-related Productivity

The Health-Related Productivity Questionnaire (HRPQ) is a generic measure of the impact of disease on the ability of the participant to be productive at paid employment or at performance of household chores. Questions inquire about the amount of time they were scheduled/planned to work, the number of the scheduled/planned hours they were able to work and their ability to be productive for the hours of work they did perform. Absenteeism: Number of hours not worked due to PD or it's treatments; Presenteeism: Number of hours of lost productivity while at work due to PD or it's treatments; Total hours lost: Number of hours lost due to absenteeism and presenteeism

Time frame: Baseline, Week 12 and Week 60

Population: Efficacy dataset with available data. Workplace hours lost is calculated for participants who were employed.

ArmMeasureGroupValue (MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in Health-related ProductivityWorkplace Work Lost - Absenteeism-2.1 hoursStandard Deviation 4.63
Levodopa-Carbidopa Intestinal GelChange From Baseline in Health-related ProductivityHousehold Work Lost - Absenteeism-3.5 hoursStandard Deviation 11.19
Levodopa-Carbidopa Intestinal GelChange From Baseline in Health-related ProductivityWorkplace Work Lost - Presenteeism-0.8 hoursStandard Deviation 13.04
Levodopa-Carbidopa Intestinal GelChange From Baseline in Health-related ProductivityHousehold Work Lost - Presenteeism-1.8 hoursStandard Deviation 6.42
Levodopa-Carbidopa Intestinal GelChange From Baseline in Health-related ProductivityTotal Workplace Work Lost-3.0 hoursStandard Deviation 8.87
Levodopa-Carbidopa Intestinal GelChange From Baseline in Health-related ProductivityTotal Household Work Lost-5.3 hoursStandard Deviation 15.69
OverallChange From Baseline in Health-related ProductivityTotal Workplace Work Lost-5.5 hoursStandard Deviation 4.5
OverallChange From Baseline in Health-related ProductivityWorkplace Work Lost - Absenteeism-5.2 hoursStandard Deviation 6.27
OverallChange From Baseline in Health-related ProductivityHousehold Work Lost - Presenteeism-1.9 hoursStandard Deviation 5.42
OverallChange From Baseline in Health-related ProductivityHousehold Work Lost - Absenteeism-1.9 hoursStandard Deviation 8.38
OverallChange From Baseline in Health-related ProductivityTotal Household Work Lost-3.8 hoursStandard Deviation 11.26
OverallChange From Baseline in Health-related ProductivityWorkplace Work Lost - Presenteeism-0.3 hoursStandard Deviation 3.87
Secondary

Change From Baseline in Mean Daily Normalized Off Time Based on Parkinson's Disease Diary

The Parkinson's Disease Diary was completed by the participant for 3 consecutive days prior to each visit for the full 24 hours of each day. Participants recorded whether they had been On, Off, or Asleep and the severity of their dyskinesias (troublesome or not troublesome) for each 30-minute period during their normal waking time and upon awakening from time asleep. Off time was defined as time when medication has worn off and was no longer providing benefit with regard to mobility, slowness, and stiffness. Parkinson's Disease Diary times were normalized to a 16-hour waking time to account for variation in participants' sleep time. Normalized PD Diary times at a given visit were calculated as the average normalized time from the PD Diary for the 3 days prior to the visit.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in Mean Daily Normalized Off Time Based on Parkinson's Disease DiaryWeek 12-4.1 hoursStandard Error 0.39
Levodopa-Carbidopa Intestinal GelChange From Baseline in Mean Daily Normalized Off Time Based on Parkinson's Disease DiaryWeek 60-4.9 hoursStandard Error 0.48
Secondary

Change From Baseline in Mean Daily Normalized On Time Without Troublesome Dyskinesia Based on PD Diary

The PD Diary was completed by the participant for 3 consecutive days prior to each visit. Participants recorded whether they had been On, Off, or Asleep and the severity of their dyskinesias (troublesome or not troublesome) for each 30-minute period during their normal waking time and upon awakening from sleep. On was defined as time when medication was providing benefit with regard to mobility, slowness, and stiffness. On time without troublesome dyskinesia is a composite of On time without dyskinesia (involuntary twisting, turning movements which are an effect of medication) plus On time with non-troublesome dyskinesia (dyskinesia that does not interfere with function or cause meaningful discomfort). PD Diary times were normalized to a 16-hour waking time to account for variation in participants' sleep time. Normalized PD Diary times at a given visit were calculated as the average normalized time from the PD Diary for the 3 days prior to the visit.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in Mean Daily Normalized On Time Without Troublesome Dyskinesia Based on PD DiaryWeek 123.7 hoursStandard Error 0.48
Levodopa-Carbidopa Intestinal GelChange From Baseline in Mean Daily Normalized On Time Without Troublesome Dyskinesia Based on PD DiaryWeek 604.3 hoursStandard Error 0.58
Secondary

Change From Baseline in NMSS Attention/Memory Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS attention/memory domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Attention/Memory Domain ScoreWeek 12-2.1 units on a scaleStandard Error 0.8
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Attention/Memory Domain ScoreWeek 60-2.2 units on a scaleStandard Error 0.87
Secondary

Change From Baseline in NMSS Cardiovascular Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS cardiovascular including falls domain score ranges from 0 to 24 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time points

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Cardiovascular Domain ScoreWeek 12-0.2 units on a scaleStandard Error 0.37
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Cardiovascular Domain ScoreWeek 600.5 units on a scaleStandard Error 0.41
Secondary

Change From Baseline in NMSS Gastrointestinal Tract Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS gastrointestinal tract domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Gastrointestinal Tract Domain ScoreWeek 12-2.0 units on a scaleStandard Error 0.6
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Gastrointestinal Tract Domain ScoreWeek 60-1.9 units on a scaleStandard Error 0.67
Secondary

Change From Baseline in NMSS Miscellaneous Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS miscellaneous domain score ranges from 0 to 48 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Miscellaneous Domain ScoreWeek 12-3.4 units on a scaleStandard Error 1
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Miscellaneous Domain ScoreWeek 60-3.4 units on a scaleStandard Error 1.11
Secondary

Change From Baseline in NMSS Mood/Cognition Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS mood/cognition domain score ranges from 0 to 72 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Mood/Cognition Domain ScoreWeek 120.0 units on a scaleStandard Error 1.12
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Mood/Cognition Domain ScoreWeek 600.5 units on a scaleStandard Error 1.24
Secondary

Change From Baseline in NMSS Perceptual Problems/Hallucinations Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS perceptual problems/hallucinations domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Perceptual Problems/Hallucinations Domain ScoreWeek 12-0.5 units on a scaleStandard Error 0.38
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Perceptual Problems/Hallucinations Domain ScoreWeek 600.4 units on a scaleStandard Error 0.43
Secondary

Change From Baseline in NMSS Sexual Function Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS sexual function domain score ranges from 0 to 24 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Sexual Function Domain ScoreWeek 12-1.8 units on a scaleStandard Error 0.42
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Sexual Function Domain ScoreWeek 60-1.1 units on a scaleStandard Error 0.47
Secondary

Change From Baseline in NMSS Sleep/Fatigue Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS sleep/fatigue domain score ranges from 0 to 48 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Sleep/Fatigue Domain ScoreWeek 12-6.0 units on a scaleStandard Error 1.17
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Sleep/Fatigue Domain ScoreWeek 60-5.4 units on a scaleStandard Error 1.29
Secondary

Change From Baseline in NMSS Urinary Domain Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; domain scores are obtained by summing the item scores. The NMSS urinary domain score ranges from 0 to 36 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Urinary Domain ScoreWeek 12-2.2 units on a scaleStandard Error 1.07
Levodopa-Carbidopa Intestinal GelChange From Baseline in NMSS Urinary Domain ScoreWeek 600.1 units on a scaleStandard Error 1.19
Secondary

Change From Baseline in Parkinson's Disease Questionnaire-39 Item (PDQ-39) Summary Index

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). The PDQ-39 Summary Index (PDQ-SI) is the sum of all answers divided by the highest score possible (i.e., number of answers multiplied by 4) which is multiplied by 100 to put the score on a 0 - 100 scale where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in Parkinson's Disease Questionnaire-39 Item (PDQ-39) Summary IndexWeek 12-11.2 units on a scaleStandard Error 2.75
Levodopa-Carbidopa Intestinal GelChange From Baseline in Parkinson's Disease Questionnaire-39 Item (PDQ-39) Summary IndexWeek 60-10.2 units on a scaleStandard Error 2.63
Secondary

Change From Baseline in PDQ-39 Activities of Daily Living Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Activities of Daily Living Domain ScoreWeek 12-12.1 units on a scaleStandard Error 4.43
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Activities of Daily Living Domain ScoreWeek 60-11.9 units on a scaleStandard Error 4.23
Secondary

Change From Baseline in PDQ-39 Bodily Discomfort Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Bodily Discomfort Domain ScoreWeek 12-9.6 units on a scaleStandard Error 4.4
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Bodily Discomfort Domain ScoreWeek 60-3.8 units on a scaleStandard Error 3.65
Secondary

Change From Baseline in PDQ-39 Cognition Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Cognition Domain ScoreWeek 12-8.4 units on a scaleStandard Error 2.23
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Cognition Domain ScoreWeek 60-7.3 units on a scaleStandard Error 2
Secondary

Change From Baseline in PDQ-39 Communication Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Communication Domain ScoreWeek 12-13.0 units on a scaleStandard Error 3.24
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Communication Domain ScoreWeek 60-10.8 units on a scaleStandard Error 2.59
Secondary

Change From Baseline in PDQ-39 Emotional Well-Being Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Emotional Well-Being Domain ScoreWeek 12-4.9 units on a scaleStandard Error 3.14
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Emotional Well-Being Domain ScoreWeek 60-6.6 units on a scaleStandard Error 3.74
Secondary

Change From Baseline in PDQ-39 Mobility Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Mobility Domain ScoreWeek 12-18.5 units on a scaleStandard Error 4.39
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Mobility Domain ScoreWeek 60-19.4 units on a scaleStandard Error 4.21
Secondary

Change From Baseline in PDQ-39 Social Support Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Social Support Domain ScoreWeek 121.6 units on a scaleStandard Error 2.62
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Social Support Domain ScoreWeek 603.3 units on a scaleStandard Error 2.95
Secondary

Change From Baseline in PDQ-39 Stigma Domain Score

The PDQ-39 is a self-administered questionnaire which comprises 39 items addressing eight domains of health (mobility \[10 items\], activities of daily living \[six items\], emotional wellbeing \[six items\], stigma \[four items\], communication \[three items\] and bodily discomfort \[three items\]) which subjects consider to be adversely affected by the disease. Each item is scored on the following 5-point scale: 0 = Never, 1 = Occasionally, 2 = Sometimes, 3 = Often, 4 = Always (or cannot do at all, if applicable). Domain scores are calculated by summing the answers to the questions in the domain, dividing by the highest score possible and then multiplying by 100 to put the score on a scale from 0 to 100, where lower scores indicate a better perceived health status and higher scores are associated with the more severe symptoms of the disease such as tremors and stiffness.

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Stigma Domain ScoreWeek 12-9.5 units on a scaleStandard Error 2.38
Levodopa-Carbidopa Intestinal GelChange From Baseline in PDQ-39 Stigma Domain ScoreWeek 60-5.4 units on a scaleStandard Error 3.01
Secondary

Change From Baseline in UPDRS Dyskinesia Items Score

The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The dyskinesia items score includes questions 32, 33 and 34 from the complications of therapy section of the UPDRS which address dyskinesia duration, disability, and pain. Each question was answered on a scale from 0 (Normal) to 4 (Severe); the UPDRS dyskinesia items score was computed as the sum of these items and ranged from 0 (not affected) to 12 (most severely affected).

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Dyskinesia Items ScoreWeek 12-1.1 units on a scaleStandard Error 0.28
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Dyskinesia Items ScoreWeek 60-0.6 units on a scaleStandard Error 0.36
Secondary

Change From Baseline in UPDRS Part II: Activities of Daily Living (ADL) Score

The Unified Parkinson's Disease Rating Scale (UPDRS) is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The activities of daily living score includes 13 items addressing speech, salivation, swallowing, handwriting, cutting food, dressing, hygiene, turning in bed, falling, freezing, walking, tremor, and sensory complaints. Each question is answered on a scale from 0 (Normal) to 4 (Severe). The UPDRS Part II: activities of daily living score was computed as the sum of these items and ranged from 0 (not affected) to 52 (most severely affected).

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at baseline (37) and at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part II: Activities of Daily Living (ADL) ScoreWeek 12-5.5 units on a scaleStandard Error 0.89
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part II: Activities of Daily Living (ADL) ScoreWeek 60-4.7 units on a scaleStandard Error 0.92
Secondary

Change From Baseline in UPDRS Part III: Motor Examination Score

The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The motor examination score includes 17 items addressing speech, facial expression, tremor at rest, action tremor, rigidity, finger taps, hand movements, hand pronation and supination, leg agility, arising from chair, posture, gait, postural stability, and body bradykinesia. Each question is answered on a scale from 0 (Normal) to 4 (Severe), some items include multiple grades for each extremity. The UPDRS Part III: motor examination score was computed as the sum of these items and ranged from 0 (not affected) to 108 (most severely affected).

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at baseline (37) and at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part III: Motor Examination ScoreWeek 12-5.6 units on a scaleStandard Error 1.19
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part III: Motor Examination ScoreWeek 60-3.6 units on a scaleStandard Error 1.49
Secondary

Change From Baseline in UPDRS Part I: Mentation, Behavior, and Mood Score

The Unified Parkinson's Disease Rating Scale (UPDRS) is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The mentation, behavior, and mood score includes 4 items addressing intellectual impairment, thought disorder, motivation/initiative, and depression. Each question is answered on a scale from 0 (None) to 4 (Severe). The UPDRS Part I: mentation, behavior, and mood score was computed as the sum of these items and ranged from 0 (not affected) to 16 (most severely affected).

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at baseline (37) and each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part I: Mentation, Behavior, and Mood ScoreWeek 12-0.3 units on a scaleStandard Error 0.31
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part I: Mentation, Behavior, and Mood ScoreWeek 60-0.1 units on a scaleStandard Error 0.26
Secondary

Change From Baseline in UPDRS Part IV: Complications of Therapy Score

The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The complications of therapy section includes 11 items addressing dyskinesia duration, disability, and pain, early morning dystonia, offs-predictable, offs-unpredictable, offs-sudden, offs-duration, anorexia-nausea-vomiting, sleep disturbance, and symptomatic orthostasis. Four questions are answered on a scale from 0 (Normal) to 4 (Severe) and seven on a binary scale where 0=No and 1=Yes. The UPDRS Part IV: complications of therapy score was computed as the sum of these items and ranged from 0 (not affected) to 23 (most severely affected).

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part IV: Complications of Therapy ScoreWeek 12-3.5 units on a scaleStandard Error 0.44
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part IV: Complications of Therapy ScoreWeek 60-2.9 units on a scaleStandard Error 0.57
Secondary

Change From Baseline in UPDRS Part V: Modified Hoehn and Yahr Staging Score

The UPDRS is an investigator-used rating tool to follow the longitudinal course of Parkinson's disease. The UPDRS assessment was performed by an approved, trained rater. The UPDRS was made up of the following sections: * Part I - Mentation, Behavior, and Mood * Part II - Activities of Daily Living * Part III - Motor Examination * Part IV - Complications of Therapy (including dyskinesias) * Part V - Modified Hoehn and Yahr Staging The modified Hoehn and Yahr scale is as follows: * Stage 0: No signs of disease * Stage 1.0: Symptoms are very mild; unilateral involvement only * Stage 1.5: Unilateral and axial involvement * Stage 2: Bilateral involvement without impairment of balance * Stage 2.5: Mild bilateral disease with recovery on pull test * Stage 3: Mild to moderate bilateral disease; some postural instability; physically independent * Stage 4: Severe disability; still able to walk or stand unassisted * Stage 5: Wheelchair bound or bedridden unless aided

Time frame: Baseline and Week 12 and Week 60

Population: Efficacy dataset with available data at each time point

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part V: Modified Hoehn and Yahr Staging ScoreWeek 12-0.2 units on a scaleStandard Error 0.1
Levodopa-Carbidopa Intestinal GelChange From Baseline in UPDRS Part V: Modified Hoehn and Yahr Staging ScoreWeek 60-0.2 units on a scaleStandard Error 0.12
Secondary

Change From Baseline to Week 60 in the Non-Motor Symptom Scale (NMSS) Total Score

The NMSS measures the frequency and severity of a range of non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous (pain, taste/smell, weight change, excessive sweating). Severity is rated on a scale from 0 (none) to 3 (severe) and frequency is rated on a scale from 1 (rarely) to 4 (very frequent). Item scores are calculated as the product of severity and frequency; the total score is obtained by summing the item scores. The NMSS total score ranges from 0 to 360 with a lower score indicating fewer symptoms; a negative change from baseline indicates improvement in symptoms.

Time frame: Baseline and Week 60

Population: Efficacy dataset with available data at baseline and week 60

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Levodopa-Carbidopa Intestinal GelChange From Baseline to Week 60 in the Non-Motor Symptom Scale (NMSS) Total Score-11.8 units on a scaleStandard Error 3.95
p-value: 0.004Mixed-effect Repeated Measures (MMRM)
Secondary

Number of Participants Who Used Healthcare Resources During the First 4 Weeks

Use of healthcare resources was assessed by the investigator using the Health Resource Utilization Questionnaire (HRUQ), a questionnaire developed by the Sponsor regarding the use of healthcare resources due to the participant's Parkinson's disease. The Week 4 version of the questionnaire addressed the following questions during the first four weeks after the PEG-J procedure: 1. Has the subject had a visit to an emergency room? 2. Has the subject had a visit to an urgent care? 3. Has the subject had an outpatient visit to a neurologist? 4. Has the subject had an outpatient visit to a gastroenterologist, surgeon, or interventional radiologist? 5. Has the subject had an outpatient visit to a primary care physician? 6. Has the subject called the nursing support line? 7. Has the subject called a physician?

Time frame: Weeks 1-4

Population: The Safety dataset included all participants who underwent the PEG-J placement procedure

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ1. Emergency Room Visit3 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ2. Urgent Care Visit0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ3. Neurologist Visit6 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ4. Gastroenterologist, Surgeon, Radiologist Visit11 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ5. Primary Care Physician Visit8 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ6. Called Nursing Support Line9 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources During the First 4 WeeksQ7. Called Physician13 Participants
Secondary

Number of Participants Who Used Healthcare Resources Through Week 60

Use of healthcare resources was assessed by the investigator using the Health Resource Utilization Questionnaire (HRUQ), a questionnaire developed by the Sponsor regarding the use of healthcare resources due to the participant's Parkinson's disease. The standard version of the questionnaire addressed the following questions over the last 3 months: 1. Has the subject had a visit to an emergency room? 2. Has the subject had an outpatient visit to any of the following healthcare providers? 3. Has the subject been visited in his or her place of residence by a health care professional? 4. Has the subject received assistance from either of the following for their Parkinson's disease in their home? 5. Has the subject needed to contact either of the following for immediate assistance related to their Parkinson's disease? 6. Have family members or friends had to miss any paid work due to the subject's Parkinson's disease? 7. Has the subject fallen during the past month?

Time frame: Week 60

Population: Safety dataset with available data

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q1. Emergency Room Visit1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Primary Care Physician18 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Gastroenterologist3 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Interventional Radiologist1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Surgeon1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Cardiologist1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Endocrinologist0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Immunologist0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Internist1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Psychiatrist0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Urologist2 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Psychologist1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Social Worker2 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q2. Visit to Other Healthcare Provider10 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q3. Visited by Physician0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q3. Visited by Nurse or Nurse Practitioner1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q3. Visited by Physical or Occupational Therapist0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q4. Received Unpaid Care From Family/Friend10 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q4. Received Care From Paid Caregiver2 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q5. Called 9110 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q5. Called Family/Friend1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q6. Family/Friends Missed Work2 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants Who Used Healthcare Resources Through Week 60Q7. Fall During Past Month10 Participants
Secondary

Number of Participants With Adverse Events

Adverse events (AEs) related to treatment are those the investigator determined as having a reasonable possibility being related to study drug based on evidence to suggest a causal relationship between the study drug and the adverse event. A severe AE was defined as an adverse event that caused considerable interference with the participant's usual activities and might be incapacitating or life-threatening. Serious AEs were defined as those that were life-threatening or resulted in death, hospitalization or prolongation of hospitalization, a congenital anomaly, persistent or significant disability/incapacity, or important medical events requiring medical or surgical intervention to prevent a serious outcome.

Time frame: Weeks 1-4 and Overall (from Week 1 through 30 days after the end of the LCIG Treatment Period; median duration of LCIG device exposure was 428 days)

Population: The Safety dataset

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsAE related to LCIG26 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsAE leading to premature discontinuation1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsSevere adverse event1 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsGastrointestinal (GI) adverse event22 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsAE related to oral LC4 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsAdverse event other than GI21 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsSerious adverse event3 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsFatal adverse event0 Participants
Levodopa-Carbidopa Intestinal GelNumber of Participants With Adverse EventsAny adverse event28 Participants
OverallNumber of Participants With Adverse EventsFatal adverse event1 Participants
OverallNumber of Participants With Adverse EventsAny adverse event37 Participants
OverallNumber of Participants With Adverse EventsAE related to LCIG35 Participants
OverallNumber of Participants With Adverse EventsAE related to oral LC11 Participants
OverallNumber of Participants With Adverse EventsSevere adverse event5 Participants
OverallNumber of Participants With Adverse EventsSerious adverse event8 Participants
OverallNumber of Participants With Adverse EventsAE leading to premature discontinuation5 Participants
OverallNumber of Participants With Adverse EventsGastrointestinal (GI) adverse event28 Participants
OverallNumber of Participants With Adverse EventsAdverse event other than GI37 Participants
Secondary

Percentage of Participants With a Patient Global Impression of Change (PGIC) Response of Improved

The PGIC is a 7-point response scale. Participants were asked to rate their change in status using the following 7-point scale: 1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. The responses of Very much improved, Much improved and Minimally improved on the PGIC were used to define responders.

Time frame: Week 12 and Week 60

Population: Efficacy dataset

ArmMeasureGroupValue (NUMBER)
Levodopa-Carbidopa Intestinal GelPercentage of Participants With a Patient Global Impression of Change (PGIC) Response of ImprovedWeek 1278.9 percentage of participants
Levodopa-Carbidopa Intestinal GelPercentage of Participants With a Patient Global Impression of Change (PGIC) Response of ImprovedWeek 6071.1 percentage of participants
Secondary

Treatment Satisfaction Questionnaire Scores

The Treatment Satisfaction Questionnaire (TSQ) is a single item instrument developed by the Sponsor on which the participant indicated their level of satisfaction or dissatisfaction with their PD treatment. The responses are recorded on a Likert-type scale (Very Satisfied, Satisfied, Somewhat Satisfied, Somewhat Dissatisfied, Dissatisfied, Very Dissatisfied).

Time frame: Week 12 and Week 60

Population: Efficacy dataset

ArmMeasureCategoryValue (COUNT_OF_PARTICIPANTS)
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresSomewhat satisfied4 Participants
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresDissatisfied1 Participants
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresSatisfied14 Participants
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresVery dissatisfied0 Participants
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresSomewhat dissatisfied1 Participants
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresMissing3 Participants
Levodopa-Carbidopa Intestinal GelTreatment Satisfaction Questionnaire ScoresVery satisfied15 Participants
OverallTreatment Satisfaction Questionnaire ScoresMissing10 Participants
OverallTreatment Satisfaction Questionnaire ScoresVery satisfied14 Participants
OverallTreatment Satisfaction Questionnaire ScoresSatisfied9 Participants
OverallTreatment Satisfaction Questionnaire ScoresSomewhat satisfied3 Participants
OverallTreatment Satisfaction Questionnaire ScoresSomewhat dissatisfied1 Participants
OverallTreatment Satisfaction Questionnaire ScoresDissatisfied0 Participants
OverallTreatment Satisfaction Questionnaire ScoresVery dissatisfied1 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026