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SHR Neuro Cancer Cardio Lipid Metab Microb
Trenkwalder, C; Chaudhuri, KR; García Ruiz, PJ; LeWitt, P; Katzenschlager, R; Sixel-Döring, F; Henriksen, T; Sesar, Á; Poewe, W; Expert Consensus Group for Use of Apomorphine in Parkinson's Disease; Baker, M; Ceballos-Baumann, A; Deuschl, G; Drapier, S; Ebersbach, G; Evans, A; Fernandez, H; Isaacson, S; van Laar, T; Lees, A; Lewis, S; Martínez Castrillo, JC; Martinez-Martin, P; Odin, P; O'Sullivan, J; Tagaris, G; Wenzel, K.
Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson's disease--Clinical practice recommendations.
Parkinsonism Relat Disord. 2015; 21(9):1023-1030
Doi: 10.1016/j.parkreldis.2015.06.012
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- Abstract:
- Extensive published evidence supports the use of subcutaneously-administered apomorphine as an effective therapy for Parkinson's disease (PD) but to date no consensus recommendations have been available to guide healthcare professionals in the optimal application of apomorphine therapy in clinical practice. This document outlines best-practice recommendations for selecting appropriate candidates for apomorphine intermittent injection (the pen-injection formulation) or apomorphine continuous infusion (the pump formulation), for initiating patients onto therapy and for managing their ongoing treatment. Apomorphine is a suitable therapeutic option for PD patients who experience troublesome 'off' periods despite optimized treatment with oral PD medications. Due to its speed of onset, apomorphine injection is particularly suited to those patients requiring rapid, reliable relief of both unpredictable and predictable 'off' periods, those who require reliable and fast relief when anticipating an 'off', those with levodopa absorption or gastric emptying problems resulting in delayed or failed 'on', or for rapid relief of early morning dystonia or akinesia. Apomorphine infusion(1) is suited for patients whose 'off' periods can no longer be adequately controlled by standard oral PD treatment or for those in whom rescue doses of apomorphine injection are effective but either needed too frequently (more than 4-6 times per day), or are associated with increasing dyskinesia. In addition to treating motor fluctuations, there is evidence that apomorphine infusion may be effective for the management of specific non-motor symptoms of PD associated with 'off' periods. Apomorphine infusion is less invasive than other non-oral treatment options for advancing disease, intrajejunal levodopa infusion and deep-brain stimulation. Copyright © 2015 Elsevier Ltd. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Antiparkinson Agents - standards
- Antiparkinson Agents - therapeutic use
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- Parkinson Disease - drug therapy
- Practice Patterns, Physicians' - standards
- Find related publications in this database (Keywords)
- Parkinson's disease
- Treatment
- Clinical practice
- Apomorphine injection
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