Lecigon is a new gel formulation of a fixed combination of levodopa, carbidopa and entacapone for continuous intestinal use in advanced PD. It combines the favourable dynamics of continuous intestinal infusion with the benefits of a dopa catechol-O-methyltransferase (COMT) inhibitor, entacapone, in an easy-to-use pump-based treatment. It is an evolution of Stalevo, a widely used oral therapeutic in earlier stages of PD. Lecigon is formulated and designed for individuals with advanced PD.
Levodopa is a precursor of dopamine and mediates the anti-parkinsonian effect, whereas carbidopa and entacapone modify the metabolism of levodopa to increase and prolong brain exposure to levodopa and to decrease dopamine-related side effects outside the brain. The continuous intestinal administration of Lecigon is administered with a small and accurate pump enabling a dosage within the narrowing therapeutic window in advanced PD. The delivery directly into the intestine circumvents the limitations of erratic gastric emptying and short plasma half-life of levodopa.
The addition of the COMT inhibitor entacapone increases the bioavailability of levodopa and thereby allows the use of lower doses and volumes of levodopa and carbidopa. Thus, the addition of entacapone in Lecigon enables the use of a smaller primary container as well as a smaller and lighter pump.
The lower dose of levodopa and carbidopa required in the presence of entacapone, not only enables the use of a smaller container and pump system, but is also in line with clinical concerns about potential side effects of high levodopa and carbidopa doses.