Short-term continuous infusion of apomorphine hydrochloride for treatment of Huntington's chorea: A double blind, randomized cross-over trial.
We evaluated tolerability and the efficacy of continuous infusion of apomorphine hydrochloride on involuntary movements and mood disorder in Huntington's disease (HD) patients in a pilot, single center, double-blind, randomized, crossover, and controlled versus placebo study. Nine patients with a molecular diagnosis of HD were screened for response to acute apomorphine injection. Four of them, not ameliorating at the acute test, were discontinued. Five patients, responding to acute apomorphine, received continuous infusion of either apomorphine or placebo for 5 days. After 2 days of washout, the alternative treatment was administered. Primary endpoint measures were scores of the Unified Huntington's Disease Rating Scale (UHDRS "motor section") and of the Abnormal Involuntary Movement Scale (AIMS). Secondary endpoint measures were the Hamilton Depression Rating Scale (HAD) score and safety parameters. Both UHDRS and AIMS scores significantly decreased in all patients after apomorphine. The beneficial effect of apomorphine was recorded throughout the 5 treatment days. The HAD score did not change after infusion of either treatment. No serious adverse events were reported by either group during the study. Our results suggest that continuous infusion of apomorphine might be considered for the treatment of involuntary movements in some HD patients.
Vitale
Carmine
C
Department of Neurological Sciences, University Federico II, Naples, Italy.
Marconi
Stefano
S
Di Maio
Luigi
L
De Michele
Giuseppe
G
Longo
Katia
K
Bonavita
Vincenzo
V
Barone
Paolo
P
D000328:Adult; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001058:Apomorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003863:Depression / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D009068:Movement / Q000187:drug effects; D009069:Movement Disorders / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales
D000978:Antiparkinson Agents; D001058:Apomorphine