Long-term effect of apomorphine infusion in advanced Parkinson’s disease: a real-life study

Abstract Long-term effects of continuous subcutaneous apomorphine infusion (CSAI) on health-related quality of life (HRQoL) and predictors of CSAI discontinuation are poorly known. Data from consecutive advanced Parkinson’s disease patients treated in routine care were retrospectively collected over...

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Autores principales: Bruna Meira, Bertrand Degos, Elise Corsetti, Mohamed Doulazmi, Emeline Berthelot, Clara Virbel-Fleischman, Pauline Dodet, Aurélie Méneret, Louise-Laure Mariani, Cécile Delorme, Florence Cormier-Dequaire, David Bendetowicz, Nicolas Villain, Clément Tarrano, Lise Mantisi, Hélène Letrillart, Céline Louapre, Eavan McGovern, Yulia Worbe, David Grabli, Marie Vidailhet, Elodie Hainque, Emmanuel Roze
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/f346fe136aee4bfcb71a0c5f818bfacc
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Sumario:Abstract Long-term effects of continuous subcutaneous apomorphine infusion (CSAI) on health-related quality of life (HRQoL) and predictors of CSAI discontinuation are poorly known. Data from consecutive advanced Parkinson’s disease patients treated in routine care were retrospectively collected over 24 months after CSAI initiation, with a focus on the 39-item Parkinson’s disease questionnaire (PDQ-39). We determined predictors of CSAI discontinuation and HRQoL improvement using multiple regression analysis. Of the 110 subjects evaluated over a 2-year period, 35% discontinued CSAI. Of those who continued treatment, HRQoL remained stable with a sustained reduction in motor fluctuations. The observed effect on dyskinesias was mild and transient. Of note, patients with preexisting impulse control disorders showed an overall good tolerability. PDQ-39 was the only baseline predictor of HRQoL improvement after 2 years of treatment. The presence of dyskinesias, poorer psychological status, shorter disease duration, male sex, and worse OFF state were predictors of discontinuation. Best candidates for CSAI are patients with: (i) poor baseline HRQoL and (ii) marked motor fluctuations.