Long-term safety and efficacy of apomorphine infusion in Parkinson's disease patients with persistent motor fluctuations: Results of the open-label phase of the TOLEDO study
| Autor: | Tove Henriksen, Olivier Rascol, Regina Katzenschlager, Andrew J. Lees, Guenther Deuschl, Teus van Laar, Claudia Trenkwalder, Donna Lockhart, K. Ray Chaudhuri, Werner Poewe, Harry Staines |
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| Přispěvatelé: | Movement Disorder (MD) |
| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine Dyskinesia Drug-Induced Infusions Apomorphine Drug-Related Side Effects and Adverse Reactions Outcome Assessment Nausea Dopamine Agonists/administration & dosage Infusions Subcutaneous Placebo Infusion Site 03 medical and health sciences 0302 clinical medicine Double-Blind Method Dyskinesia Drug-Induced/etiology Outcome Assessment Health Care medicine Humans Apomorphine/administration & dosage Parkinson Disease/drug therapy Adverse effect Aged Dyskinesia business.industry Subcutaneous Parkinson Disease Middle Aged Drug-Induced/etiology Health Care 030104 developmental biology Neurology Tolerability Anesthesia Dopamine Agonists Female Neurology (clinical) Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery Somnolence medicine.drug |
| Zdroj: | Parkinsonism & Related Disorders, 83, 79-85. Elsevier |
| ISSN: | 1353-8020 |
| DOI: | 10.1016/j.parkreldis.2020.12.024 |
| Popis: | Introduction: The randomized, double-blind phase (DBP) of the TOLEDO study confirmed the efficacy of apomorphine infusion (APO) in reducing OFF time in PD patients with persistent motor fluctuations despite optimized oral/transdermal therapy. Here we report safety and efficacy results including the 52-week open-label phase (OLP).Methods: All patients completing the 12-week DBP (including those switching early to open-label treatment) were offered OLP entry. The primary objective was the evaluation of long-term safety of APO.Results: Eighty-four patients entered the OLP (40 previously on APO, 44 on placebo) and 59 patients (70.2%) completed the study. The safety profile of APO was consistent with experience from extensive clinical use. Common treatment-related adverse events (AEs) were mild or moderate infusion site nodules, somnolence and nausea. Fourteen (16.7%) patients discontinued the OLP due to AEs, those involving >1 patient were infusion site reactions (n = 4) and fatigue (n = 2); hemolytic anemia occurred in one case. Reduction in daily OFF time and improvement in ON time without troublesome dyskinesia were sustained for up to 64 weeks. Pooled data for week 64 (n = 55) showed a mean (SD) change from DBP baseline in daily OFF time of-3.66 (2.72) hours and in ON time without troublesome dyskinesia of 3.31 (3.12) hours. Mean (+/- SD) daily levodopa-equivalent dose decreased from DBP baseline to week 64 by 543 mg (+/- 674) and levodopa dose by 273 mg (+/- 515).Conclusions: The safety and efficacy of APO infusion were demonstrated with long-term use for persistent motor fluctuations, allowing substantial reductions in oral PD medication. |
| Databáze: | OpenAIRE |
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