What is Duodopa pump treatment?
Applied options for the treatment of advanced stage of Parkinson’s disease are very limited. Both in Turkey and in the world, treatment in form of Deep Brain Stimulation (DBS) and Apomorphine injection pump are available. Recently, another alternative has been added to these treatments in our country. Levodopa/Carbidopa intestinal gel, also known as Duodopa, is a form of Levodopa which is accepted as the gold standard in the treatment of Parkinson’s disease, as a continuous infusion of the small intestinal. Duodopa, in fact, is not a new treatment. It was first clinically applied in 1991 in Sweden. Nowadays, including Germany, France, Italy and Belgium this method, which has been used for years in many European countries, is now being applied in our country.
What is Duodopa?
Duodopa is a gel containing Levodopa/Carbidopa which is administered as infusion from the small intestine. It provides continuous and constant speed dopamine stimulation to the brain via a special pump. This gel is administered as a continuous infusion to the jejunum part of the small intestines by means of a special pump. Therefore, it is given directly to the place where Levodopa is best absorbed, allowing it to reach the brain quickly and to act by transforming into Dopamine in the brain. The pre-programmability of the Duodopa pump makes it possible to individualize the daily dose of Levodopa according to the needs of each patient and even to adjust the treatment dose due to the patients’ needs if necessary. Thus, the patients daily need for Levodopa is applied in continuous and constant doses, fluctuations in the blood level of the drug are minimized, thereby unwanted effects significantly.
Duodopa is applied with a system called percutaneous endoscopic gastrojejunostomy. This system is inserted into the stomach and extended to the small intestine be means of a bowel tube. The Duodopa pump is attached to the outside end of the tube. Duodopa is more effective than oral treatments in term of motor fluctuations and quality of life. Duodopa treatment is an important option especially in patients with motor fluctuations, involuntary movements, stiffness and tremors and who provide decreased response to the medicine over time, and unable to tolerate oral medicine use.
Why the pump treatment used?
By the pump treatment the drugs are transferred into the body and the brain without any interruption and the symptoms of the disease are kept under control. This treatment eliminates the need for oral medication many times during the day.