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Updated: Aug 5, 2026
08:06
Murine Model for Parkinson's Disease: from 6-OH Dopamine Lesion to Behavioral Test
Published on: January 15, 2010
Initiating Apomorphine Therapy Without Antiemetic Pretreatment: Real-World Data From a Nurse-led Parkinson Disease
Cindy Happel1, Mindy Grall, Andrea Formella
1Cindy Happel, Mindy Grall, Andrea Formella, Supernus Pharmaceuticals Inc., Rockville, MD.
Summary
Subcutaneous apomorphine injection (SC-APO) is now commonly initiated without antiemetic pretreatment for Parkinson disease patients. This approach shows higher early treatment continuation rates, suggesting improved patient management.
Area of Science:
- Neurology
- Pharmacology
- Clinical Practice
Background:
- Trimethobenzamide was the standard antiemetic for subcutaneous apomorphine injection (SC-APO) in Parkinson disease.
- Production cessation of trimethobenzamide led to SC-APO initiation without antiemetic pretreatment.
Purpose of the Study:
- To compare SC-APO starting doses and 90-day continuation rates before and after trimethobenzamide absence.
- To evaluate the impact of SC-APO labeling changes on treatment initiation.
Main Methods:
- Analysis of data from a SC-APO Clinical Nurse Navigator support program (January 2019-March 2024).
- Comparison of SC-APO starting doses and 90-day continuation between patients with and without antiemetic pretreatment.
Main Results:
- SC-APO initiation without trimethobenzamide increased from 32.8% to nearly 100% by end of 2021.
- 90-day SC-APO continuation rates improved from 75.4% (with trimethobenzamide) to 83.1% (without).
- Starting dose shifted from 0.2 mL to 0.1 mL following a 2022 labeling update.
Conclusions:
- SC-APO is now routinely initiated without antiemetic pretreatment, with improved early treatment continuation.
- Flexible dosing, titration, and nurse-led support enhance SC-APO treatment initiation and continuation.
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