Subcutaneous apomorphine in Parkinson's disease: response to chronic administration for up to five years.
Identifieur interne : 004A11 ( Ncbi/Curation ); précédent : 004A10; suivant : 004A12Subcutaneous apomorphine in Parkinson's disease: response to chronic administration for up to five years.
Auteurs : A J Hughes [Royaume-Uni] ; S. Bishop ; B. Kleedorfer ; N. Turjanski ; W. Fernandez ; A J Lees ; G M SternSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1993.
English descriptors
- KwdEn :
- Adult, Aged, Apomorphine (administration & dosage), Apomorphine (adverse effects), Female, Follow-Up Studies, Humans, Infusion Pumps, Injections, Subcutaneous, Levodopa (administration & dosage), Levodopa (adverse effects), Long-Term Care, Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (drug therapy).
- MESH :
- chemical , administration & dosage : Apomorphine, Levodopa.
- chemical , adverse effects : Apomorphine, Levodopa.
- drug effects : Neurologic Examination.
- drug therapy : Parkinson Disease.
- Adult, Aged, Female, Follow-Up Studies, Humans, Infusion Pumps, Injections, Subcutaneous, Long-Term Care, Male, Middle Aged.
Abstract
Subcutaneous apomorphine, administered by continuous waking-day infusion with boluses, or by repeated intermittent injection, was given to 71 parkinsonian patients with severe refractory levodopa related on-off fluctuations for 1-5 years. A mean reduction in daily off period time of approximately 50% was maintained, and the incidence of neuropsychiatric toxicity remained low on long-term follow-up. No clinically significant tolerance or loss of therapeutic effect was seen, although increasingly severe on-phase dyskinesias and postural instability marred the long-term therapeutic response in many patients. Despite these drawbacks, apomorphine, when combined with the peripheral dopamine receptor agonist domperidone, represents a significant therapeutic advance in the management of late-stage Parkinson's disease and should certainly be considered before experimental implantation procedures.
DOI: 10.1002/mds.870080208
PubMed: 8474483
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pubmed:8474483Le document en format XML
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<author><name sortKey="Hughes, A J" sort="Hughes, A J" uniqKey="Hughes A" first="A J" last="Hughes">A J Hughes</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Middlesex Hospital, London, England.</nlm:affiliation>
<country>Royaume-Uni</country>
<placeName><region type="country">Angleterre</region>
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<wicri:cityArea>Department of Neurology, Middlesex Hospital, London</wicri:cityArea>
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<author><name sortKey="Bishop, S" sort="Bishop, S" uniqKey="Bishop S" first="S" last="Bishop">S. Bishop</name>
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<author><name sortKey="Kleedorfer, B" sort="Kleedorfer, B" uniqKey="Kleedorfer B" first="B" last="Kleedorfer">B. Kleedorfer</name>
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<author><name sortKey="Turjanski, N" sort="Turjanski, N" uniqKey="Turjanski N" first="N" last="Turjanski">N. Turjanski</name>
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<author><name sortKey="Fernandez, W" sort="Fernandez, W" uniqKey="Fernandez W" first="W" last="Fernandez">W. Fernandez</name>
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<author><name sortKey="Lees, A J" sort="Lees, A J" uniqKey="Lees A" first="A J" last="Lees">A J Lees</name>
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<author><name sortKey="Stern, G M" sort="Stern, G M" uniqKey="Stern G" first="G M" last="Stern">G M Stern</name>
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<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Middlesex Hospital, London, England.</nlm:affiliation>
<country>Royaume-Uni</country>
<placeName><region type="country">Angleterre</region>
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<wicri:cityArea>Department of Neurology, Middlesex Hospital, London</wicri:cityArea>
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<author><name sortKey="Bishop, S" sort="Bishop, S" uniqKey="Bishop S" first="S" last="Bishop">S. Bishop</name>
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<author><name sortKey="Kleedorfer, B" sort="Kleedorfer, B" uniqKey="Kleedorfer B" first="B" last="Kleedorfer">B. Kleedorfer</name>
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<author><name sortKey="Turjanski, N" sort="Turjanski, N" uniqKey="Turjanski N" first="N" last="Turjanski">N. Turjanski</name>
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<author><name sortKey="Fernandez, W" sort="Fernandez, W" uniqKey="Fernandez W" first="W" last="Fernandez">W. Fernandez</name>
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<author><name sortKey="Lees, A J" sort="Lees, A J" uniqKey="Lees A" first="A J" last="Lees">A J Lees</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Apomorphine (adverse effects)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Infusion Pumps</term>
<term>Injections, Subcutaneous</term>
<term>Levodopa (administration & dosage)</term>
<term>Levodopa (adverse effects)</term>
<term>Long-Term Care</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurologic Examination (drug effects)</term>
<term>Parkinson Disease (drug therapy)</term>
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<term>Levodopa</term>
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<term>Levodopa</term>
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<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term>
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<term>Aged</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Infusion Pumps</term>
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<term>Male</term>
<term>Middle Aged</term>
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<front><div type="abstract" xml:lang="en">Subcutaneous apomorphine, administered by continuous waking-day infusion with boluses, or by repeated intermittent injection, was given to 71 parkinsonian patients with severe refractory levodopa related on-off fluctuations for 1-5 years. A mean reduction in daily off period time of approximately 50% was maintained, and the incidence of neuropsychiatric toxicity remained low on long-term follow-up. No clinically significant tolerance or loss of therapeutic effect was seen, although increasingly severe on-phase dyskinesias and postural instability marred the long-term therapeutic response in many patients. Despite these drawbacks, apomorphine, when combined with the peripheral dopamine receptor agonist domperidone, represents a significant therapeutic advance in the management of late-stage Parkinson's disease and should certainly be considered before experimental implantation procedures.</div>
</front>
</TEI>
</record>
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