Chronic subcutaneous infusion therapy with apomorphine in advanced Parkinson's disease compared to conventional therapy: a real life study of non motor effect.

Abstract

BACKGROUND:

Apomorphine infusion therapy remains under-used and there are no comparative studies of motor and non-motor effects of apomorphine infusion.

METHODS:

In this paper we report preliminary results from an ongoing clinical observational "real life" surveillance-based study focused on effects of this therapy on non-motor symptoms and health-related quality of life in a group of patients on apomorphine.

RESULTS:

Apomorphine infusion led to highly significant improvements in UPDRS 3 (p = 0.0003), UPDRS 4 (p = 0.0003), PDQ-8 (Parkinson's disease questionnaire, p = 0.001) and NMSS total (non motor symptoms scale, p = 0.0003). Furthermore, apomorphine was tolerated in patients with visual hallucinations, illusions and paranoid ideations while significant improvement in specific non-motor symptoms such as hyperhidrosis, nocturia, urgency of micturition, and fatigue was recorded. Levodopa equivalent dose decreased significantly (1077.81 ± 446.26 to 458.75 ± 282.29, p < 0.0001) and a large effect size of intervention was noted. In an untreated group no such improvement was noted. The number needed to treat (NNT) for improvement >1 SEM in the Apo group was calculated and was lower than 2 for >1 SEM improvement of UPDRS 3, NMSS, and PDQ-8 total scores.

CONCLUSIONS:

This pilot observational study suggests that non-motor effects are evident with apomorphine therapy and patients suitable for apomorphine deteriorate in the absence of therapy.

• Authors: Pablo Martinez-Martin, Prashanth Reddy, Angelo Antonini, Tove Henriksen, Regina Katzenschlager, Per Odin, Antonia Todorova, Yogini Naidu, Susanne Tluk, Chandni Chandiramani, Anne Martin, Kallol Ray Chaudhuri
• Journal: Journal of Parkinson's disease (J Parkinsons Dis) Vol. 1 Issue 2 Pg. 197-203 ( 2011) ISSN: 1877-718X [Electronic] Netherlands
• PMID: 23934921 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dopamine Agonists
• Apomorphine

Topics

• Aged
• Apomorphine (administration & dosage)
• Chi-Square Distribution
• Dopamine Agonists (administration & dosage)
• Drug Administration Routes
• Female
• Humans
• Infusions, Subcutaneous
• Male
• Middle Aged
• Observation
• Parkinson Disease (complications, drug therapy)
• Pilot Projects
• Quality of Life
• Severity of Illness Index