title: Intermittent subcutaneous apomorphine therapy for 'off' episodes in Parkinson's disease: a 6-month open-label study.
abstract: OBJECTIVE
  The outpatient follow-up phase of the apomorphine (APO) 303 study assessed the long-term efficacy and safety of intermittent subcutaneous apomorphine for 'off' episodes in patients with advanced Parkinson's disease.
  
  
  METHODS
  We conducted a 6-month open-label outpatient extension of an in-office dose-escalation study. Patients received apomorphine at a dose considered optimal based on safety and efficacy assessments during the dose-titration phase. Outpatient evaluation visits were scheduled at 1 and 2 weeks, and 1, 4 and 6 months. Efficacy parameters included changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor scores; safety assessments included blood pressure (BP) monitoring.
  
  
  RESULTS
  Apomorphine significantly (p<0.05) reduced UPDRS motor scores at 20, 40 and 90 minutes post-dose versus pre-dose at all evaluation visits. Significant (p<0.1) reductions from pre-dose in seated and standing systolic BP and diastolic BP were noted at various timepoints post-dose at evaluation visits; however, the changes did not increase over the course of the outpatient phase. The incidence of symptomatic hypotension also did not increase with long-term apomorphine use.
  
  
  CONCLUSIONS
  The efficacy and general tolerability of subcutaneous apomorphine throughout this open-label outpatient study suggest that it is suitable for the long-term acute treatment of 'off' episodes in patients with advanced Parkinson's disease.
authors.affiliation: The Parkinson's Disease and Movement Disorders Center, Southfield, Michigan 48034, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Trosch
authors.forename: Dee
authors.initials: D
authors.lastname: Silver
authors.forename: Peter B
authors.initials: PB
authors.lastname: Bottini
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001058:Apomorphine / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous / Q000379:methods; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010300:Parkinson Disease / Q000188:drug therapy*; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000978:Antiparkinson Agents; D001058:Apomorphine