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. 2021 Jun 11;7(1):50.
doi: 10.1038/s41531-021-00194-7.

Long-term effect of apomorphine infusion in advanced Parkinson's disease: a real-life study

Bruna Meira  1 , Bertrand Degos  2 , Elise Corsetti  3 , Mohamed Doulazmi  4 , Emeline Berthelot  5 , Clara Virbel-Fleischman  6   7 , Pauline Dodet  7   8 , Aurélie Méneret  3   7 , Louise-Laure Mariani  3   7 , Cécile Delorme  3   7 , Florence Cormier-Dequaire  3   7 , David Bendetowicz  3   7 , Nicolas Villain  3   7   9 , Clément Tarrano  3   7 , Lise Mantisi  3 , Hélène Letrillart  3 , Céline Louapre  3   7 , Eavan McGovern  3 , Yulia Worbe  3   10 , David Grabli  3   7 , Marie Vidailhet  3   7 , Elodie Hainque  3   7 , Emmanuel Roze  11   12
Affiliations

Long-term effect of apomorphine infusion in advanced Parkinson's disease: a real-life study

Bruna Meira et al. NPJ Parkinsons Dis. .

Abstract

Long-term effects of continuous subcutaneous apomorphine infusion (CSAI) on health-related quality of life (HRQoL) and predictors of CSAI discontinuation are poorly known. Data from consecutive advanced Parkinson's disease patients treated in routine care were retrospectively collected over 24 months after CSAI initiation, with a focus on the 39-item Parkinson's disease questionnaire (PDQ-39). We determined predictors of CSAI discontinuation and HRQoL improvement using multiple regression analysis. Of the 110 subjects evaluated over a 2-year period, 35% discontinued CSAI. Of those who continued treatment, HRQoL remained stable with a sustained reduction in motor fluctuations. The observed effect on dyskinesias was mild and transient. Of note, patients with preexisting impulse control disorders showed an overall good tolerability. PDQ-39 was the only baseline predictor of HRQoL improvement after 2 years of treatment. The presence of dyskinesias, poorer psychological status, shorter disease duration, male sex, and worse OFF state were predictors of discontinuation. Best candidates for CSAI are patients with: (i) poor baseline HRQoL and (ii) marked motor fluctuations.

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Conflict of interest statement

B.D. served on scientific advisory boards for Aguettant, received research support from Orkyn and Elivie, and received travel grant from Orkyn and Elivie; E.B. received travel grant from Vitalaire and PEPS; C.V.-F. received a grant from Association Nationale de la Recherche et de la Technologie and full-time employment by Air Liquide Healthcare; P.D. received a travel grant from UCB pharma; A.M. received travel funding from AbbVie and Merz; L.-L.M. received speech honoraria from Lundbeck and Teva and received travel funding from the Medtronic, Teva, and AbbVie; C.D. received travel grant from Medtronic and Boston Scientific; D.B. received travel grant from Boston Scientific; L.M. received a travel grant from Orkyn (Air Liquide), Abbvie, Elivie, and Medtronic; H.L. received a travel grant from Orkyn (Air Liquide), Abbvie, and Elivie; E.M. received travel grant from Elivie; D.G. served on scientific advisory boards for AbbVie and Zambon, received speech honoraria from Medtronic and Abbvie, received research support from Air Liquide, and received travel grant from Abbvie; E.H. served on scientific advisory boards for Medtronic and Boston Scientific, received honoraria for speeches from Boston Scientific, and received travel grant from Merz; E.R. served on scientific advisory boards for Orkyn and Aguettant, received honoraria for speeches from Orkyn, Aguettant, and EVER Pharma, received research support from Orkyn, Aguettant, Elivie, and EVER Pharma, and received travel grant from Vitalaire, PEPS development, Aguettant, Orkyn, Elivie, and Adelia Medical. B.M, E.C., M.D., F.C.D., N.V, C.T., C.L., Y.W., and M.V. declare absence of commercial or financial relationships that could be construed as potential conflicts of interest.

Figures

Fig. 1
Fig. 1. Study flow chart.
CSAI continuous subcutaneous apomorphine infusion, PDQ-39 Parkinson disease questionnaire 39.
Fig. 2
Fig. 2. Comparison of HRQoL measured by PDQ-39.
The evolution of each dimension of PDQ-39 at baseline (M0) and at each follow-up visit (M3, M6, M12, M24).
Fig. 3
Fig. 3. Satisfaction self-assessment questionnaire.
Histograms illustrating the proportion of patients for each score on the five items of the treatment satisfaction self-questionnaire. Motor fluctuations was the item with the largest percentage of patients stating improvement (83–91%). Quality of life was improved in 76–82% of patients and dyskinesias in 64–76%. Gait and swallowing disturbances showed a more modest percentage (60–73%). 0 = very much improved, 1 = moderately improved, 2 = little improved, 3 = not improved, and 4 = deteriorated.
See this image and copyright information in PMC

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