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EuroInf: A Multicenter Comparative Observational Study of Apomorphine and Levodopa Infusion in Parkinson's Disease

Martinez-Martin, Pablo; Reddy, Prashanth; Katzenschlager, Regina; Antonini, Angelo; Todorova, Antoniya; Odin, Per LU ; Henriksen, Tove; Martin, Anne; Calandrella, Daniela and Rizos, Alexandra, et al. (2015) In Movement Disorders 30(4). p.510-516
Abstract
Subcutaneous apomorphine infusion (Apo) and intrajejunal levodopa infusion (IJLI) are two treatment options for patients with advanced Parkinson's disease (PD) and refractory motor complications, with varying cost of treatment. There are no multicenter studies comparing the effects of the two strategies. This open-label, prospective, observational, 6-month, multicenter study compared 43 patients on Apo (48.8% males, age 62.3 +/- 10.6 years; disease duration: 14 +/- 4.4 years; median H & Y stage 3; interquartile range [IQR]: 3-4) and 44 on IJLI (56.8% males, age 62.7 +/- 9.1 years; disease duration: 16.1 +/- 6.7 years; median H & Y stage 4; IQR, 3-4). Cohen's effect sizes (0.8 considered as large) were large with both therapies with... (More)
Subcutaneous apomorphine infusion (Apo) and intrajejunal levodopa infusion (IJLI) are two treatment options for patients with advanced Parkinson's disease (PD) and refractory motor complications, with varying cost of treatment. There are no multicenter studies comparing the effects of the two strategies. This open-label, prospective, observational, 6-month, multicenter study compared 43 patients on Apo (48.8% males, age 62.3 +/- 10.6 years; disease duration: 14 +/- 4.4 years; median H & Y stage 3; interquartile range [IQR]: 3-4) and 44 on IJLI (56.8% males, age 62.7 +/- 9.1 years; disease duration: 16.1 +/- 6.7 years; median H & Y stage 4; IQR, 3-4). Cohen's effect sizes (0.8 considered as large) were large with both therapies with respect to total motor, nonmotor, and quality-of-life scores. The Non-Motor Symptoms Scale (NMSS) with Apo showed moderate improvement, whereas sleep/fatigue, gastrointestinal, urinary, and sexual dimensions of the NMSS showed significantly higher improvement with IJLI. Seventy-five percent on IJLI improved in their quality-of-life and nonmotor symptoms (NMS), whereas in the Apo group, a similar proportion improved in quality of life, but 40% in NMS. Adverse effects included peritonitis with IJLI and skin nodules on Apo. Based on this open-label, nonrandomized, comparative study, we report that, in advanced Parkinson's patients, both IJLI and Apo infusion therapy appear to provide a robust improvement in motor symptoms, motor complications, quality-of-life, and some NMS. Controlled, randomized studies are required. (c) 2014 International Parkinson and Movement Disorder Society (Less)
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Contribution to journal
publication status
published
subject
keywords
Parkinson's disease, nonmotor symptoms, apomorphine infusion, intrajejunal levodopa infusion, quality of life
in
Movement Disorders
volume
30
issue
4
pages
510 - 516
publisher
John Wiley & Sons
external identifiers
  • wos:000352614200009
  • scopus:84964241167
ISSN
0885-3185
DOI
10.1002/mds.26067
language
English
LU publication?
yes
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7983953e-fc33-447c-adee-55a1d2b55ca8 (old id 5401677)
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2015-06-01 09:23:32
date last changed
2017-11-05 03:13:02
@article{7983953e-fc33-447c-adee-55a1d2b55ca8,
  abstract     = {Subcutaneous apomorphine infusion (Apo) and intrajejunal levodopa infusion (IJLI) are two treatment options for patients with advanced Parkinson's disease (PD) and refractory motor complications, with varying cost of treatment. There are no multicenter studies comparing the effects of the two strategies. This open-label, prospective, observational, 6-month, multicenter study compared 43 patients on Apo (48.8% males, age 62.3 +/- 10.6 years; disease duration: 14 +/- 4.4 years; median H & Y stage 3; interquartile range [IQR]: 3-4) and 44 on IJLI (56.8% males, age 62.7 +/- 9.1 years; disease duration: 16.1 +/- 6.7 years; median H & Y stage 4; IQR, 3-4). Cohen's effect sizes (0.8 considered as large) were large with both therapies with respect to total motor, nonmotor, and quality-of-life scores. The Non-Motor Symptoms Scale (NMSS) with Apo showed moderate improvement, whereas sleep/fatigue, gastrointestinal, urinary, and sexual dimensions of the NMSS showed significantly higher improvement with IJLI. Seventy-five percent on IJLI improved in their quality-of-life and nonmotor symptoms (NMS), whereas in the Apo group, a similar proportion improved in quality of life, but 40% in NMS. Adverse effects included peritonitis with IJLI and skin nodules on Apo. Based on this open-label, nonrandomized, comparative study, we report that, in advanced Parkinson's patients, both IJLI and Apo infusion therapy appear to provide a robust improvement in motor symptoms, motor complications, quality-of-life, and some NMS. Controlled, randomized studies are required. (c) 2014 International Parkinson and Movement Disorder Society},
  author       = {Martinez-Martin, Pablo and Reddy, Prashanth and Katzenschlager, Regina and Antonini, Angelo and Todorova, Antoniya and Odin, Per and Henriksen, Tove and Martin, Anne and Calandrella, Daniela and Rizos, Alexandra and Bryndum, Narissah and Glad, Arne and Dafsari, Haidar Salimi and Timmermann, Lars and Ebersbach, Georg and Kramberger, Milica G. and Samuel, Michael and Wenzel, Karoline and Tomantschger, Volker and Storch, Alexander and Reichmann, Heinz and Pirtosek, Zvezdan and Trost, Maja and Svenningsson, Per and Palhagen, Sven and Volkmann, Jens and Chaudhuri, K. Ray},
  issn         = {0885-3185},
  keyword      = {Parkinson's disease,nonmotor symptoms,apomorphine infusion,intrajejunal levodopa infusion,quality of life},
  language     = {eng},
  number       = {4},
  pages        = {510--516},
  publisher    = {John Wiley & Sons},
  series       = {Movement Disorders},
  title        = {EuroInf: A Multicenter Comparative Observational Study of Apomorphine and Levodopa Infusion in Parkinson's Disease},
  url          = {http://dx.doi.org/10.1002/mds.26067},
  volume       = {30},
  year         = {2015},
}