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Night-Time Apomorphine Infusion: Who Are the Best Candidates?
Valérie Cochen De Cock1,2, Pauline Dodet3, Smaranda Leu-Semenescu3
1Sleep and Neurology Department Beau Soleil Clinic Montpellier France.
Background:
We recently demonstrated in a randomized controlled trial (APOMORPHEE, NCT02940912) that night-time only subcutaneous apomorphine infusion improves sleep disturbances and insomnia in patients with advanced Parkinson's disease and moderate to severe insomnia.
Objectives:
To identify the best candidates for receiving night-time only subcutaneous apomorphine infusion in routine care.
Methods:
In this post-hoc analysis of APOMORPHEE, we compared the characteristics of patients according to whether they chose to continue night-time only subcutaneous apomorphine infusion at the end of the study period or not.
Results:
Half of the patients (22/42) chose to continue the treatment. Off duration (day or night), painful Off dystonia, and insomnia severity at baseline were associated with night-time only apomorphine continuation. Multivariate analysis retained only Off duration as an independent predictor of continuation.
Conclusions:
The best candidates for night-time only apomorphine are patients with severe and prolonged Off periods (day or night) and severe insomnia.
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