Early factors for predicting discontinuation to subcutaneous Apomorphine infusion in Parkinson's disease

Autor: Chanawat Anan, Roongroj Bhidayasiri, Teus van Laar, K. Ray Chaudhuri, Aukkritthiwat Phimpha, Onanong Phokaewvarangkul
Přispěvatelé: Movement Disorder (MD)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Parkinson's disease
Apomorphine
Timed Up and Go test
Infusions
Subcutaneous
Antiparkinson Agents
Levodopa
Withholding Treatment/statistics & numerical data
Prospective analysis
Risk Factors
Prospective Studies
Registries
Parkinson Disease/drug therapy
Parkinson Disease
Middle Aged
Thailand
Infusions
Subcutaneous/statistics & numerical data
Treatment Outcome
Neurology
Anesthesia
Time and Motion Studies
Female
medicine.symptom
Subcutaneous/statistics & numerical data
medicine.drug
Infusions
Levodopa/administration & dosage
Motor Activity/drug effects
Motor Activity
Thai apomorphine registry
Apomorphine therapy
medicine
Antiparkinson Agents/administration & dosage
Humans
Apomorphine/administration & dosage
Aged
business.industry
medicine.disease
Discontinuation
Dyskinesia
Withholding Treatment
Neurology (clinical)
Electronic database
Geriatrics and Gerontology
CONSENSUS
business
Follow-Up Studies
Zdroj: Parkinsonism & Related Disorders, 91, 146-151. Elsevier
ISSN: 1353-8020
DOI: 10.1016/j.parkreldis.2021.09.022
Popis: INTRODUCTION: Although continuous subcutaneous apomorphine infusion (CSAI) is an effective therapy for Parkinson's disease (PD) with motor fluctuations, data from Asian cohorts is limited. The therapy is often discontinued due to the complexity of its delivery.METHODS: Fifty-one PD patients undergoing CSAI as an add-on therapy were enrolled in the Thai Apomorphine Registry, an electronic database that recorded clinical characteristics and parameters during the 14-consecutive-day titration and long-term follow-up. Factors at the time of titration were documented in order to identify predictors of long-term discontinuation.RESULTS: Following initiation, PD patients were administered a mean CSAI dose of 5.89 mg/h (SD 1.36) over a mean time of 12.28 h (SD 1.90) each day. The mean follow-up period was 626.2 days (SD 619.17). Significant reductions in UPDRS-I, II, III, and IV scores, total NMSQ score, PDQ-8 score, daily off and dyskinesia hours, Timed Up and Go test, walking step test, levodopa-equivalent daily dose, number of times a day the levodopa was taken versus pre-CSAI values were observed (p < 0.05, each). Thirty-five (68.6%) patients discontinued during the follow-up period. Relative risks of variables recorded at the time of titration that determined discontinuation of CSAI therapy were an absence of full-time caregivers, achieving a daily off hours reduction CONCLUSION: Identifying factors that predict discontinuation of CSAI at the time of its initiation may help physicians to better understand the patient's drug response and how to manage them long-term.
Databáze: OpenAIRE
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