Clinical Impact of Switching from Subcutaneous Apomorphine to Foslevodopa/Foscarbidopa in Advanced Parkinson's...

Continuous subcutaneous foslevodopa/foscarbidopa (CSFLI) is emerging as a new treatment for advanced Parkinson's disease (APD), but its efficacy and safety as a second-line infusion therapy in patients previously treated with apomorphine remain to be clarified.

The aim of this study was to evaluate the short-term clinical impact of switching from continuous subcutaneous apomorphine infusion (CSAI) to CSFLI in a real-world cohort.

We conducted a retrospective observational study including 14 patients with APD who transitioned from CSAI to CSFLI. Clinical assessments were performed at baseline (M0) and 3 months after the switch (M3).

At M3, motor complications (Movement Disorder Society-the Unified Parkinson's Disease Rating Scale [MDS-UPDRS Part IV]) were significantly reduced, with improvements in functional scores (Part II), quality of life (Parkinson's Disease Questionnaire-8 [PDQ-8]), clinical global impression of severity (CGI-S), and neuropsychiatric inventory (NPI). No patient discontinued treatment. Two patients developed de novo apathy.

Switching from CSAI to CSFLI is feasible, effective, and well tolerated. Behavioral changes observed in two cases underline the need for clinical awareness when treating patients with subtle cognitive vulnerability.