Practical use of apomorphine infusion in Parkinson's disease: lessons from the TOLEDO study and clinical experience.


Journal

Journal of neural transmission (Vienna, Austria : 1996)
ISSN: 1435-1463
Titre abrégé: J Neural Transm (Vienna)
Pays: Austria
ID NLM: 9702341

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 31 07 2023
accepted: 15 08 2023
medline: 15 11 2023
pubmed: 2 9 2023
entrez: 1 9 2023
Statut: ppublish

Résumé

Subcutaneous apomorphine infusion is a device-aided therapy for Parkinson's disease that can be considered when motor fluctuations become persistent and are no longer adequately controlled by oral/transdermal medication. Apomorphine infusion is less invasive than enteral levodopa, deep brain stimulation or focused ultrasound, and is often indicated even when neurosurgical approaches are contraindicated. This article aims to provide practical guidance for doctors and nurses initiating and treating patients with apomorphine infusion, and is based on both trial data and clinical experience from movement disorders specialists. A post hoc analysis of data from the TOLEDO randomized clinical trial of apomorphine infusion was conducted along with an analysis of 'real world' experience from 13 movement disorders specialists using a questionnaire that focused on starting patients on apomorphine infusion. Practical guidelines for starting treatment with apomorphine infusion are provided taking into consideration the regional disparities in healthcare. Apomorphine infusion is straightforward to administer but to be successful it requires concordance from the patient and family, and clinical support from an experienced team of doctors and nurses, particularly in the early months of treatment.

Identifiants

pubmed: 37658155
doi: 10.1007/s00702-023-02686-7
pii: 10.1007/s00702-023-02686-7
pmc: PMC10645621
doi:

Substances chimiques

Apomorphine N21FAR7B4S
Antiparkinson Agents 0
Levodopa 46627O600J

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1475-1484

Informations de copyright

© 2023. The Author(s).

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Auteurs

Tove Henriksen (T)

Department of Neurology, Movement Disorder Clinic, University Hospital of Bispebjerg, 2400, Copenhagen, Denmark. tovehenriksen@dadlnet.dk.

Regina Katzenschlager (R)

Department of Neurology and Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Klinik Donaustadt, Vienna, Austria.

Roongroj Bhidayasiri (R)

Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.

Harry Staines (H)

Sigma Statistical Services, Balmullo, UK.

Donna Lockhart (D)

Britannia Pharmaceuticals Limited, Reading, Berkshire, UK.

Andrew Lees (A)

University College London Institute of Neurology and the National Hospital, Queen Square, London, UK.

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Classifications MeSH