title: Motor and non-motor outcomes of continuous apomorphine infusion in 125 Parkinson's disease patients.
abstract: BACKGROUND
  Continuous apomorphine infusion (CAI) is an effective treatment in fluctuating Parkinson's disease (PD). However, long-term efficacy and safety data of CAI are scarce.
  
  
  METHODS
  We retrospectively reviewed long-term outcomes of CAI on motor and non-motor symptoms in a Dutch cohort of 125 PD patients.
  
  
  RESULTS
  Our cohort (age: 65.8 ± 9.8 years, disease duration: 11.9 ± 5.7 years) had a mean daily dose of apomorphine of 66 ± 30 mg, thereby reducing the levodopa-equivalent daily dose (LEDD) by 20%. The mean duration of treatment with apomorphine was 32.3 ± 31.9 months, ranging up to 139 months. Three-quarters of patients discontinued within the first four years. The main reason for discontinuation was a decreasing therapeutic effect. Patients who stopped apomorphine within four years had a lower LEDD reduction at hospital discharge and at last follow-up compared to patients who continued for a longer period. CAI showed good effects on motor fluctuations and dyskinesia, with better outcomes in patients with more pronounced LEDD reduction. CAI could be safely applied in patients with pre-existing visual hallucinations (30%).
  
  
  CONCLUSIONS
  CAI showed beneficial effects on motor and several non-motor symptoms, whereas the magnitude of LEDD reduction seems to be a positive predictive factor on the duration of CAI.
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Robbert W K
authors.initials: RW
authors.lastname: Borgemeester
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Martje
authors.initials: M
authors.lastname: Drent
authors.affiliation: Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: t.van.laar@umcg.nl.
authors.forename: Teus
authors.initials: T
authors.lastname: van Laar
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D001058:Apomorphine / Q000008:administration & dosage*; D005260:Female; D006212:Hallucinations / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D055104:Infusions, Subcutaneous; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D001058:Apomorphine
keywords: Apomorphine; Dyskinesia; Motor fluctuations; Parkinson's disease; Visual hallucinations