A novel sublingual apomorphine treatment for patients with fluctuating
Parkinson's disease
W Ondo, C Hunter, M Almaguer, J Jankovic
Mov Dis 1999;14:664-668
A new apomorphine preparation is well-tolerated and allows a large
reduction in levodopa dose without decrease in antiparkinson benefit,
according to this open study.
Ten patients with motor fluctuations and dyskinesia received sublingual,
sustained- release apomorphine (210 mg/day, in either 3 or 6 doses) for
3
months, with levodopa dose adjusted to maximize "on" time and minimize
dyskinesia.
Mean levodopa dose decreased from 855 mg/day to 580 mg/day (32%
decrease),
while mean "on" time increased from 73.5% to 81.5%. Dyskinesia did not
decrease significantly. Performance on apomorphine alone (after 12-hour
levodopa washout) was superior to levodopa alone for "on" UPDRS parts II
and III. No patients discontinued due to adverse events. Of three
patients
who discontinued the drug at the study's end, only one patient did so
because of drug effects.
The authors conclude, "The ease of use, comparable efficacy to levodopa,
and longer duration of effect achieved by this [apomorphine] preparation
suggest that it could possibly replace levodopa as a primary treatment
for
PD."
Copyright 1998 WE MOVE
Editor: Richard Robinson ([log in to unmask])
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