Foslevodopa/Foscarbidopa Continuous Subcutaneous Infusion in Parkinson's Disease: Real‐World Short‐Term Data on Tolerability, Infusion Rate Adjustments and Concomitant Medication

BACKGROUND: Foslevodopa/foscarbidopa (LDp/CDp) significantly reduced motor fluctuations in people with Parkinson's disease (PwP) in clinical trials, but its real-world tolerability and optimal dosing remain unclear. OBJECTIVES: To assess tolerability, dosing patterns, and modifications to concomitant medication with LDp/CDp in clinical practice. METHODS: A single-center retrospective cross-sectional analysis. RESULTS: The LDp/CDp was initiated in 53 PwP (41% women, mean age 66 ± 11.3 years, mean disease duration 14.1 ± 5.7 years, median H history of cognitive impairment: 40%, history of psychosis: 62%, previous device aided therapies failure: 39%). After an optimization period (18.4 ± 6.8 days), the mean Base hourly infusion rate was significantly higher than recommended (0.39 ± 0.18 vs. 0.32 ± 0.13 ml/h, p < 0.001) and the LDp/CDp was co-administered with MAO-B-inhibitors (50%), COMT-inhibitors (44%), and dopamine agonists (12%). Adverse events occurred in 40%: skin reactions (31%), psychosis (8%), falls (2%), and nausea (2%). Thirteen patients discontinued therapy. CONCLUSIONS: LDp/CDp may be an effective and well-tolerated non-surgical option for managing motor fluctuations in PD, though higher dosing and combination therapy are often required.