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Apomorphine: an underutilized therapy for Parkinson's disease
1Department of Neurology, University Hospital Innsbruck, Austria.
Movement Disorders : Official Journal of the Movement Disorder Society
|September 29, 2000
Summary
Subcutaneous apomorphine injections effectively treat Parkinson's disease motor fluctuations, offering benefits comparable to levodopa. Continuous infusions significantly reduce off-time and may lessen dyskinesias, with manageable side effects.
Area of Science:
- Neurology
- Pharmacology
Background:
- Apomorphine, the first dopaminergic drug, has a long history in Parkinson's disease (PD) treatment.
- Recent studies focus on subcutaneous apomorphine for fluctuating PD symptoms.
Purpose of the Study:
- To evaluate the efficacy and tolerability of subcutaneous apomorphine in managing Parkinson's disease fluctuations.
- To compare subcutaneous apomorphine with other PD therapies.
Main Methods:
- Systematic review of clinical trials on intermittent and continuous subcutaneous apomorphine administration.
- Analysis of long-term efficacy and side effect profiles.
Main Results:
- Intermittent apomorphine injections provide antiparkinsonian benefits similar to levodopa.
- Continuous subcutaneous apomorphine infusions reduce daily off-time by over 50% in fluctuating PD.
- Monotherapy with continuous infusions shows potential for reducing levodopa-induced dyskinesias.
- Long-term efficacy (up to 8 years) and manageable side effects (primarily cutaneous) were observed.
Conclusions:
- Subcutaneous apomorphine is a highly effective treatment for fluctuating Parkinson's disease.
- Continuous infusions offer significant benefits, potentially superior to oral adjunct therapies.
- Apomorphine therapy warrants wider clinical adoption for appropriate PD patients.