Evaluating apomorphine infusion for patients with Parkinson’s disease and motor fluctuations

This study evaluated the safety and effectiveness of apomorphine (Apo-Go) for the treatment of motor fluctuations in patients with Parkinson’s disease (PD). The conclusion of the study was that this treatment significantly reduced “off” time (poor motor performance during periods when medications for PD have no effect) for these patients.

Levodopa is the cornerstone of PD therapy. Nerve cells use levodopa to make dopamine and replenish the brain’s reduced dopamine supply.

Long-term levodopa therapy is associated with persistent motor fluctuations. These are alternating periods of “on” time (good motor performance when medications work) and “off” time. Apomorphine is a drug that mimics dopamine. This can help boost the brain’s low dopamine supply. The safety and effectiveness of this treatment for patients with PD remain under investigation.

This study evaluated the safety and effectiveness of apomorphine versus placebo (a substance with no active effect) in patients with PD with persistent motor fluctuations. 106 patients were included in the study. They were randomly assigned to receive infusions of either apomorphine (50%) or placebo (50%) for 12 weeks.

Apomorphine significantly decreased “off” time by an average of 2.47 hours per day compared to placebo (0.58 hours) at 12 weeks. Apomorphine significantly increased “on” time without dyskinesia (involuntary movements such as twisting or writhing) by an average of 2.77 hours per day compared to placebo (0.80 hours).

The levodopa-equivalent dose (a drug dose that has the same effects as 100 milligrams of levodopa) of other medications was significantly reduced in the apomorphine group (–492.1 milligrams) compared to placebo (–163.7 milligrams) at 12 weeks. More patients in the apomorphine group (71%) rated themselves as improved compared to the placebo group (18%) at 12 weeks.

Patients in the apomorphine group experienced a significantly higher rate of side effects (93%) compared to placebo (57%). Most side effects were mild or moderate. The most common ones included skin reactions (44%), nausea (22% vs. 9%), and drowsiness (22% vs. 4%). 5.66% of patients in the apomorphine group withdrew from the study due to side effects.

This study concluded that apomorphine significantly reduced “off” time in patients with PD, especially those with poor results from other therapies.

This study received funding support from Britannia Pharmaceuticals, the developer of apomorphine. This company was also involved in the design and data analysis of this study.

Discuss with your doctor strategies to improve motor functions.