Continuous Subcutaneous Infusion Delivery of Apomorphine beneficial in treating Parkinson's Disease

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-11-16T17:45:07+05:30 | Updated On 17 Nov 2023 11:11 AM IST

Continuous Subcutaneous Infusion Delivery of Apomorphine beneficial in treating Parkinson's Disease suggests a new study published in the Movement Disorders Clinical Practice.

Continuous subcutaneous apomorphine infusion (CSAI) is one of the advanced therapies for Parkinson's disease (PD).

A systematic review of all published articles in English on CSAI for PD till January 30, 2022 was conducted.

Results

A total of 82 articles met the search criteria. Publications included retrospective or prospective open-label observational studies, with a limited number of randomized control trials (RCT). Publications were highly heterogeneous and focused on different aspects of CSAI and included clinical audits, effects on cognition/behavior, axial symptoms, nocturnal issues, adverse events/reasons for discontinuation and comparison with other continuous dopaminergic therapies. CSAI was used in patients who presented severe motor fluctuations not resolved by oral therapy, poor candidates for deep brain stimulation (DBS) due to cognitive/behavioral issues or in those with DBS weaning effect. Recent studies have also shown that CSAI was useful for nocturnal usage in advanced PD, in addition to daytime utilization. Adverse effects were common and include skin lesions, sedation and nausea. Pump management difficulties and patient decisions were common reasons for therapy dropout, predominantly during the initial stages of the CSAI.

There is consistent agreement on the benefits of CSAI in reducing OFF periods and improving ON periods without troublesome dyskinesia and specific motor and non-motor symptoms. Although there is a paucity of RCTs, current data from almost 30 years of use suggests CSAI to be beneficial in advanced cases of PD.

Reference:

Kukkle, P.L., Garg, D. and Merello, M. (2023), Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review. Mov Disord Clin Pract. https://doi.org/10.1002/mdc3.13810

Keywords:

Kukkle, P.L., Garg, D. and Merello, M, Movement Disorders Clinical Practice, Continuous Subcutaneous, Infusion, Delivery, Apomorphine, Parkinson's Disease

Movement Disorders Clinical PracticeContinuous SubcutaneousInfusion DeliveryApomorphinebeneficialtreatingParkinson

Source : Movement Disorders Clinical Practice

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751