title: Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations: a multicenter study.
abstract: 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.
authors.affiliation: Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain. pgarcia@fjd.es
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authors.lastname: Sesar Ignacio
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authors.lastname: Mateo González
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authors.lastname: Miquel Rodríguez
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authors.lastname: Muñoz Fargas
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authors.lastname: Obeso Inchausti
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authors.lastname: Olivares Romero
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authors.lastname: Olivé Plana
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authors.lastname: Otermin Vallejo
authors.forename: Berta
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authors.lastname: Pascual Sedano
authors.forename: Víctor
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authors.lastname: Pérez de Colosía Rama
authors.forename: Isabel
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authors.lastname: Pérez López-Fraile
authors.forename: Albert
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authors.lastname: Planas Comes
authors.forename: Víctor
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authors.lastname: Puente Periz
authors.forename: María Cruz
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authors.lastname: Rodríguez Oroz
authors.forename: Dolores
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authors.lastname: Sevillano García
authors.forename: Pilar
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authors.lastname: Solís Pérez
authors.forename: José
authors.initials: J
authors.lastname: Suárez Muñoz
authors.forename: Julia
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authors.lastname: Vaamonde Gamo
authors.forename: Caridad
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authors.lastname: Valero Merino
authors.forename: Francesc
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authors.lastname: Valldeoriola Serra
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Velázquez Pérez
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authors.lastname: Yáñez Baña
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mesh_terms: 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
chemical_list: D000978:Antiparkinson Agents; D001058:Apomorphine