Scientific publications
Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson's disease with motor fluctuations: a multicenter study
Pedro J. García Ruiz (1), Ángel Sesar Ignacio (2), Begoña Ares Pensado (2), Alfonso Castro García (2), Fernando Alonso Frech (3), Mercedes Álvarez López (4), José Arbelo González (5), Joan Baiges Octavio (6), Juan Andrés Burguera Hernández (7), Matilde Calopa Garriga (8), Dulce Campos Blanco (9), Belén Castaño García (10), Manuel Carballo Cordero (11), José Chacón Peña (4), Anna Espino Ibáñez (12), Aránzazu Gorospe Onisalde (13), Santiago Giménez-Roldán (10), Pilar Granés Ibáñez (14), Jorge Hernández Vara (15), Ramón Ibáñez Alonso (16), Félix Javier Jiménez Jiménez (17), Jerzy Krupinski (8), Jaime Kulisevsky Bojarsky (18), Inés Legarda Ramírez (13), Elena Lezcano García (19), Juan Carlos Martínez-Castrillo (20), Dolores Mateo González (10), Francesc Miquel Rodríguez (15), Pablo Mir (11), Elena Muñoz Fargas (6), José Obeso Inchausti (21), Jesús Olivares Romero (22), José Olivé Plana (23), Pilar Otermin Vallejo (24), Berta Pascual Sedano (18), Víctor Pérez de Colosía Rama (25), Isabel Pérez López-Fraile (26), Albert Planas Comes (27), Víctor Puente Periz (28), María Cruz Rodríguez Oroz (21), Dolores Sevillano García (29), Pilar Solís Pérez (30), José Suárez Muñoz (31), Julia Vaamonde Gamo (16), Caridad Valero Merino (32), Francesc Valldeoriola Serra (33), José Miguel Velázquez Pérez (34), Rosa Yáñez Baña (35), Ivana Zamarbide Capdepon (1)
(1) Department of Neurology, Fundación Jiménez Díaz, Madrid, Spain
(2) Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
(3) Department of Neurology, Hospital de Fuenlabrada, Fuenlabrada, Spain
(4) Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain
(5) Department of Neurology, Hospital Insular de Gran Canaria, Las Palmas, Spain
(6) Department of Neurology, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
(7) Department of Neurology, Hospital Universitario La Fe, Valencia, Spain
(8) Department of Neurology, Hospital Príncipes de España (Bellvitge), Hospitalet de Llobregat, Spain
(9) Department of Neurology, Hospital Clínico Universitario, Valladolid, Spain
(10) Department of Neurology, Hospital Universitario Gregorio Marañón, Madrid, Spain
(11) Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
(12) Department of Neurology, Hospital Son Llàtzer, Palma de Mallorca, Spain
(13) Department of Neurology, Hospital Universitario Son Dureta, Palma de Mallorca, Spain
(14) Department of Neurology, Hospital Universitario Arnau de Vilanova, Lérida, Spain
(15) Department of Neurology, Hospital General Vall D'Hebron, Barcelona, Spain
(16) Department of Neurology, Hospital General de Ciudad Real, Ciudad Real, Spain
(17) Department of Neurology, Hospital Príncipe de Asturias, Alcalá de Henares, Spain
(18) Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(19) Department of Neurology, Hospital de Cruces, Bilbao, Spain
(20) Department of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain
(21) Department of Neurology, Clínica Universitaria de Pamplona, Pamplona, Spain
(22) Department of Neurology, Complejo Hospitalario de Torrecárdenas, Almería, Spain
(23) Department of Neurology, Hospital Sant Joan de Reus, Reus, Spain
(24) Department of Neurology, Hospital General de Granollers, Granollers, Spain
(25) Department of Neurology, Hospital de Mérida, Mérida, Spain
(26) Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, Spain
(27) Department of Neurology, Hospital Municipal De Badalona, Badalona, Spain
(28) Department of Neurology, Hospital del Mar, Barcelona, Spain
(29) Department of Neurology, Hospital Universitario de Salamanca, Salamanca, Spain
(30) Department of Neurology, Hospital Virgen de los Lirios, Alcoy, Spain
(31) Department of Neurology, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas, Spain
(32) Department of Neurology, Hospital Arnau de Vilanova, Valencia, Spain
(33) Department of Neurology, Hospital Clínic i Provincial, Barcelona, Spain
(34) Department of Neurology, Hospital Virgen de la Salud, Toledo, Spain
(35) Department of Neurology, Complejo Hospitalario de Ourense, Orense, Spain
Continuous subcutaneous apomorphine infusion (CSAI) is, at present, an alternative option for advanced Parkinson's disease (PD) with motor fluctuations.
We studied the evolution of patients with PD and severe motor fluctuations long-term treated with CSAI. We reviewed data from 82 patients with PD (mean age, 67 +/- 11.07; disease duration, 14.39 +/- 5.7 years) and severe motor fluctuations referred to 35 tertiary hospitals in Spain. These patients were long-term treated (for at least 3 months) with CSAI and tolerated the procedure without serious side effects. We compared the baseline data of these 82 patients (before CSAI) with those obtained from the last follow-up visit of each patient. The mean follow-up of CSAI was 19.93 +/- 16.3 months.
Mean daily dose of CSAI was 72.00 +/- 21.38 mg run over 14.05 +/- 1.81 hours. We found a statistically significant reduction in off-hours, according to self-scoring diaries (6.64 +/- 3.09 vs. 1.36 +/- 1.42 hours/day, P < 0.0001), total and motor UPDRS scores (P < 0.0001), dyskinesia severity (P < 0.0006), and equivalent dose of antiparkinsonian therapy (1,405 +/- 536.7 vs. 800.1 +/- 472.9 mg of levodopa equivalent units P < 0.0001). CSAI is an effective option for patients with PD and severe fluctuations, poorly controlled by conventional oral drug treatment.
CITATION Mov Disord. 2008 Jun 15;23(8):1130-6