[Intermittent apomorphine injections as rescue therapy for advanced Parkinson's disease. Consensus statement].
Intermittent subcutaneous apomorphine therapy should be considered in patients with advanced Parkinson's disease who experience recurrent off periods despite optimised oral treatment (according to guidelines), for reliable and quick reversal of these otherwise refractory periods. Such treatment is also called rescue therapy. At present, apomorphine injections with the apomorphine pen are underutilised, considering its current indications and contraindications. In the present consensus statement, concepts for the use of apomorphine are presented and discussed based on existing study results, indications, and contraindications. Recommendations for a practical approach are also provided.
Trenkwalder
C
C
Zentrum für Parkinson-Syndrome und Bewegungsstörungen, Paracelsus-Elena-Klinik, Klinikstrasse 16, 34128, Kassel, Deutschland. CTrenkwalder@gmx.de
Boesch
S
S
Ceballos-Baumann
A
A
Dressler
D
D
Eggert
K
K
Gasser
T
T
Honig
H
H
Müller
T
T
Reichmann
H
H
Sieb
J P
JP
Storch
A
A
Odin
P
P
Poewe
W
W
D000284:Administration, Oral; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001058:Apomorphine / Q000008:administration & dosage* / Q000009:adverse effects; D000075202:Contraindications; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D007267:Injections; D007279:Injections, Subcutaneous; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000188:drug therapy*
D000978:Antiparkinson Agents; D007980:Levodopa; D001058:Apomorphine