Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease
Introduction and objective Continuous subcutaneous apomorphine (APO) treatment is one of the 3 therapeutic options for advanced Parkinson’s disease (PD), in addition to deep brain stimulation (DBS) and intrajejunal levodopa. Data from previously performed studies show that few PD patients can achiev...
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Institute of Rural Health
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doaj-e9de5673012047d398b3cdb4938eb3962020-11-25T00:57:57ZengInstitute of Rural HealthAnnals of Agricultural and Environmental Medicine1232-19661898-22632019-03-0126113313710.26444/aaem/9969999699Continuous subcutaneous apomorphine monotherapy in Parkinson’s diseaseEwa Papuć0Olga Trzciniecka1Konrad Rejdak2Department of Neurology, Medical University of Lublin, PolandDepartment of Neurology, Medical University of Lublin, PolandDepartment of Neurology, Medical University of Lublin, PolandIntroduction and objective Continuous subcutaneous apomorphine (APO) treatment is one of the 3 therapeutic options for advanced Parkinson’s disease (PD), in addition to deep brain stimulation (DBS) and intrajejunal levodopa. Data from previously performed studies show that few PD patients can achieve APO infusion as monotherapy. The current pilot study presents the authors’ experience in achieving APO monotherapy. Material and methods During the last 2 years, 9 patients with APO were treated in the Department of Neurology of the Medical University of Lublin; each patient was offered a 5-day duration APO treatment as monotherapy. The main indication for the APO therapy was advanced PD with motor fluctuations and the patient’s non-agreement for DBS therapy. Mean age of treated patients – 65.11 years, mean disease duration – 7.67 years, mean Hoehn-Yahr – 2.67, mean L-dopa equivalent before APO treatment – 1751.11 mg, mean daily dose of apomorphine as monotherapy – 106.11 ± 14.09 mg. Results All treated patients managed to achieve APO monotherapy. A statistically significant reduction was found in the duration of the ‘off’ states in the observed PD patients on APO monotherapy (p<0.05). No significant improvement was observed in the III motor score of the UPDRS on APO treatment, compared to optimized oral therapy used before APO treatment. Conclusions APO monotherapy can be achieved in advanced PD, and seems to be a good therapeutic option for this group of patients, especially in that it allows a significant reduction in the off-time which significantly simplifies the drug regime. Nevertheless, hospital admission with experienced neurologist supervision is recommended when establishing a PD patient’s APO monotherapy.http://www.journalssystem.com/aaem/Continuous-subcutaneous-apomorphine-monotherapy-in-Parkinson-s-disease,99699,0,2.htmlParkinson’s diseaseapomorphinecontinuous subcutaneous infusionmonotherapyapomorphine pump |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ewa Papuć Olga Trzciniecka Konrad Rejdak |
spellingShingle |
Ewa Papuć Olga Trzciniecka Konrad Rejdak Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease Annals of Agricultural and Environmental Medicine Parkinson’s disease apomorphine continuous subcutaneous infusion monotherapy apomorphine pump |
author_facet |
Ewa Papuć Olga Trzciniecka Konrad Rejdak |
author_sort |
Ewa Papuć |
title |
Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease |
title_short |
Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease |
title_full |
Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease |
title_fullStr |
Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease |
title_full_unstemmed |
Continuous subcutaneous apomorphine monotherapy in Parkinson’s disease |
title_sort |
continuous subcutaneous apomorphine monotherapy in parkinson’s disease |
publisher |
Institute of Rural Health |
series |
Annals of Agricultural and Environmental Medicine |
issn |
1232-1966 1898-2263 |
publishDate |
2019-03-01 |
description |
Introduction and objective
Continuous subcutaneous apomorphine (APO) treatment is one of the 3 therapeutic options for advanced Parkinson’s disease (PD), in addition to deep brain stimulation (DBS) and intrajejunal levodopa. Data from previously performed studies show that few PD patients can achieve APO infusion as monotherapy. The current pilot study presents the authors’ experience in achieving APO monotherapy.
Material and methods
During the last 2 years, 9 patients with APO were treated in the Department of Neurology of the Medical University of Lublin; each patient was offered a 5-day duration APO treatment as monotherapy. The main indication for the APO therapy was advanced PD with motor fluctuations and the patient’s non-agreement for DBS therapy. Mean age of treated patients – 65.11 years, mean disease duration – 7.67 years, mean Hoehn-Yahr – 2.67, mean L-dopa equivalent before APO treatment – 1751.11 mg, mean daily dose of apomorphine as monotherapy – 106.11 ± 14.09 mg.
Results
All treated patients managed to achieve APO monotherapy. A statistically significant reduction was found in the duration of the ‘off’ states in the observed PD patients on APO monotherapy (p<0.05). No significant improvement was observed in the III motor score of the UPDRS on APO treatment, compared to optimized oral therapy used before APO treatment.
Conclusions
APO monotherapy can be achieved in advanced PD, and seems to be a good therapeutic option for this group of patients, especially in that it allows a significant reduction in the off-time which significantly simplifies the drug regime. Nevertheless, hospital admission with experienced neurologist supervision is recommended when establishing a PD patient’s APO monotherapy. |
topic |
Parkinson’s disease apomorphine continuous subcutaneous infusion monotherapy apomorphine pump |
url |
http://www.journalssystem.com/aaem/Continuous-subcutaneous-apomorphine-monotherapy-in-Parkinson-s-disease,99699,0,2.html |
work_keys_str_mv |
AT ewapapuc continuoussubcutaneousapomorphinemonotherapyinparkinsonsdisease AT olgatrzciniecka continuoussubcutaneousapomorphinemonotherapyinparkinsonsdisease AT konradrejdak continuoussubcutaneousapomorphinemonotherapyinparkinsonsdisease |
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1725221975091052544 |