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Efficacy of long‐term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations: A multicenter study

2008; Wiley; Volume: 23; Issue: 8 Linguagem: Inglês

10.1002/mds.22063

1531-8257

Pedro Ruiz, Ángel Sesar Ignacio, Begoña Ares Pensado, Alfonso Castro García, Fernando Alonso Frech, Mercedes Álvarez López, J.A. Saldivar Gonzalez, Joan Baiges Octavio, J.A. Burguera Hernández, M. Calopa Garriga, Dulce Campos Blanco, Belén Castaño García, Manuel Carballo Cordero, José Chacón Peña, Anna Espino Ibáñez, Aránzazu Gorospe Onisalde, S Giménez-Roldán, Pilar Granés Ibáñez, Jorge Hernández‐Vara, Ramón Ibáñez Alonso, Félix Javier Jiménez Jiménez, Jerzy Krupiński, Jaime Kulisevsky Bojarsky, I. Legarda Ramírez, Elena Lezcano García, Juan Carlos Martínez‐Castrillo, Dolores Mateo González, Francesc Miquel Rodríguez, Pablo Mir, E Fargas, José Obeso Inchausti, Jesús Olivares Romero, José Olivé Plana, Pilar Otermin Vallejo, Berta Pascual‐Sedano, Víctor Pérez de Colosía Rama, I Pérez López-Fraile, Albert Planas Comes, V. Puente Periz, María Rodríguez‐Oroz, Dolores Sevillano García, Pilar Solís Pérez, José Suárez Muñoz, Julia Vaamonde Gamo, Caridad Valero Merino, Francesc Valldeoriola Serra, José Miguel Velázquez Pérez, Rosa Yáñez Baña, Ivana Zamarbide Capdepón,

Botulinum Toxin and Related Neurological Disorders

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. © 2008 Movement Disorder Society.