Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations: a multicenter study.
Continuous subcutaneous apomorphine infusion (CSAI) is, at present, an alternative option for advanced Parkinson's disease (PD) with motor fluctuations. We studied the evolution of patients with PD and severe motor fluctuations long-term treated with CSAI. We reviewed data from 82 patients with PD (mean age, 67 +/- 11.07; disease duration, 14.39 +/- 5.7 years) and severe motor fluctuations referred to 35 tertiary hospitals in Spain. These patients were long-term treated (for at least 3 months) with CSAI and tolerated the procedure without serious side effects. We compared the baseline data of these 82 patients (before CSAI) with those obtained from the last follow-up visit of each patient. The mean follow-up of CSAI was 19.93 +/- 16.3 months. Mean daily dose of CSAI was 72.00 +/- 21.38 mg run over 14.05 +/- 1.81 hours. We found a statistically significant reduction in off-hours, according to self-scoring diaries (6.64 +/- 3.09 vs. 1.36 +/- 1.42 hours/day, P < 0.0001), total and motor UPDRS scores (P < 0.0001), dyskinesia severity (P < 0.0006), and equivalent dose of antiparkinsonian therapy (1,405 +/- 536.7 vs. 800.1 +/- 472.9 mg of levodopa equivalent units P < 0.0001). CSAI is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment.
García Ruiz
Pedro J
PJ
Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain. pgarcia@fjd.es
Sesar Ignacio
Angel
A
Ares Pensado
Begoña
B
Castro García
Alfonso
A
Alonso Frech
Fernando
F
Alvarez López
Mercedes
M
Arbelo González
José
J
Baiges Octavio
Joan
J
Burguera Hernández
Juan Andrés
JA
Calopa Garriga
Matilde
M
Campos Blanco
Dulce
D
Castaño García
Belén
B
Carballo Cordero
Manuel
M
Chacón Peña
José
J
Espino Ibáñez
Anna
A
Gorospe Onisalde
Aránzazu
A
Giménez-Roldán
Santiago
S
Granés Ibáñez
Pilar
P
Hernández Vara
Jorge
J
Ibáñez Alonso
Ramón
R
Jiménez Jiménez
Félix Javier
FJ
Krupinski
Jerzy
J
Kulisevsky Bojarsky
Jaime
J
Legarda Ramírez
Inés
I
Lezcano García
Elena
E
Martínez-Castrillo
Juan Carlos
JC
Mateo González
Dolores
D
Miquel Rodríguez
Francesc
F
Mir
Pablo
P
Muñoz Fargas
Elena
E
Obeso Inchausti
José
J
Olivares Romero
Jesús
J
Olivé Plana
José
J
Otermin Vallejo
Pilar
P
Pascual Sedano
Berta
B
Pérez de Colosía Rama
Víctor
V
Pérez López-Fraile
Isabel
I
Planas Comes
Albert
A
Puente Periz
Víctor
V
Rodríguez Oroz
María Cruz
MC
Sevillano García
Dolores
D
Solís Pérez
Pilar
P
Suárez Muñoz
José
J
Vaamonde Gamo
Julia
J
Valero Merino
Caridad
C
Valldeoriola Serra
Francesc
F
Velázquez Pérez
José Miguel
JM
Yáñez Baña
Rosa
R
Zamarbide Capdepon
Ivana
I
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D001058:Apomorphine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000187:drug effects; D006801:Humans; D007260:Infusion Pumps; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D001058:Apomorphine