Continuous Apomorphine Infusion in Multiple System Atrophy Real-World Insights From a French Nationwide Retrospective
Simon Lamy1, Frederique Leh2, Alexandra Foubert-Samier3,4,5
1Department of Neurology, Pontchaillou University Hospital, Rennes, France.
Movement Disorders Clinical Practice
|April 20, 2026
Summary
Continuous subcutaneous apomorphine infusion (CSAI) offers short-term benefits for multiple system atrophy (MSA) patients with motor fluctuations. This study found CSAI to be generally well-tolerated in selected MSA individuals.
Area of Science:
- Neuroscience
- Neurology
- Pharmacology
Background:
- Continuous subcutaneous apomorphine infusion (CSAI) is a recognized treatment for Parkinson's disease.
- Its efficacy and tolerability in multiple system atrophy (MSA) have not been previously evaluated.
Purpose of the Study:
- To evaluate the 6-month efficacy and tolerability of CSAI in patients diagnosed with MSA.
- To determine the clinical response and safety profile of CSAI in this specific patient population.
Main Methods:
- A French multicenter retrospective registry-based analysis was conducted.
- The primary outcome measure was the 6-month clinical response assessed by the Clinical Global Impression Improvement (CGI-I) scale.
- Secondary outcomes included tolerability, reasons for CSAI initiation, infusion parameters, and treatment duration.
Main Results:
- Fifty MSA patients, predominantly with MSA-P (94%), were included in the study.
- A significant majority (88%) experienced a clinically meaningful dopaminergic response, with CSAI initiated for motor symptoms and pain.
- At 6 months, most patients showed improvement, primarily from reduced motor fluctuations, with good/excellent tolerability reported by 74%.
Conclusions:
- CSAI demonstrated short-term clinical benefits in selected MSA patients who exhibit partial dopaminergic responsiveness and motor fluctuations.
- The treatment was found to have acceptable tolerability, with only 8% discontinuing therapy.
- CSAI can be a viable option for managing motor fluctuations and associated symptoms in specific MSA cases.
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