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. 2023 Jun 13;10(8):1192-1197.
doi: 10.1002/mdc3.13799. eCollection 2023 Aug.

Night-Time Apomorphine Infusion: Who Are the Best Candidates?

Valérie Cochen De Cock  1   2 , Pauline Dodet  3 , Smaranda Leu-Semenescu  3 , Cécile Aerts  1   2 , Beatriz Abril  4 , Giovanni Castelnovo  5 , Nicolas Landragin  6 , Sophie Drapier  7 , Hélène Olivet  8 , Anne-Gaëlle Corbillé  9 , Laurène Leclair-Visonneau  10 , Mathieu Anheim  11   12 , Marie Vidailhet  13   14 , Isabelle Arnulf  3   14 , Mohamed Doulazmi  15 , Emmanuel Roze  13   14 ; Post‐hoc analysis of the APOMORPHEE study
Affiliations

Night-Time Apomorphine Infusion: Who Are the Best Candidates?

Valérie Cochen De Cock et al. Mov Disord Clin Pract. .

Abstract

Background: We recently demonstrated in a randomized controlled trial (APOMORPHEE, NCT02940912) that night-time only subcutaneous apomorphine infusion improves sleep disturbances and insomnia in patients with advanced Parkinson's disease and moderate to severe insomnia.

Objectives: To identify the best candidates for receiving night-time only subcutaneous apomorphine infusion in routine care.

Methods: In this post-hoc analysis of APOMORPHEE, we compared the characteristics of patients according to whether they chose to continue night-time only subcutaneous apomorphine infusion at the end of the study period or not.

Results: Half of the patients (22/42) chose to continue the treatment. Off duration (day or night), painful Off dystonia, and insomnia severity at baseline were associated with night-time only apomorphine continuation. Multivariate analysis retained only Off duration as an independent predictor of continuation.

Conclusions: The best candidates for night-time only apomorphine are patients with severe and prolonged Off periods (day or night) and severe insomnia.

Keywords: Parkinson's disease; apomorphine; insomnia; motor fluctuations; sleep; sleepiness; treatment.

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