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LCIG (Duodopa) – Delivery Method — SCE Neurology MCQ

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ModerateMovement DisordersLCIG (Duodopa) – Delivery MethodSCE Neurology

A 65-year-old man with PD on co-careldopa, entacapone, and ropinirole still has 5 hours of 'off' time per day. He is not a DBS candidate. His neurologist considers levodopa-carbidopa intestinal gel (LCIG, Duodopa). How is LCIG delivered?

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Correct answer: E — Continuous infusion via a percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tube connected to a portable pump — delivering levodopa-carbidopa gel directly into the jejunum

LCIG (Duodopa) is a gel formulation of levodopa-carbidopa delivered continuously into the proximal jejunum via a PEG-J tube connected to a portable pump. Jejunal delivery bypasses gastric emptying variability (a major cause of unpredictable levodopa absorption) and provides continuous, stable levodopa plasma levels. This dramatically reduces 'off' time and dyskinesia in advanced PD patients. NICE TA128 recommends LCIG for advanced PD with severe motor fluctuations not adequately managed by oral therapy. A: Oral is what LCIG replaces. C: Not IV. D: SC is the apomorphine route. E: Nasal is not available.

Reference: NICE TA128 LCIG; BNF – Duodopa