Continued efficacy and safety of subcutaneous apomorphine in patients with advanced Parkinson's disease

The study purpose was to assess the efficacy of intermittent subcutaneous apomorphine (APO) as acute therapy for off episodes in advanced Parkinson's disease (PD) patients who had previously received APO for ≥3 months. Patients (n = 62) were randomized to receive double-blind treatment with APO at their typically effective dose (TED; APO), APO at their TED+0.2 mL (2.0 mg; APO+2), placebo at volume equal to their TED (PL), or placebo at volume equal to their TED+0.2 mL (PL+2), for a single off episode. Significantly greater improvement in mean Unified PD rating scale motor scores was seen with pooled APO versus pooled placebo 20 min after administration (-24.2 vs. -7.4; p < 0.0001); the difference was also significant at 10 min (p < 0.0001). Overall adverse event incidence did not significantly differ between pooled APO and pooled PL. This study supports the long-term use of intermittent APO as effective acute therapy for off episodes in advanced PD patients.