Bret S. Stetka, MD; Robbert Borgemeester, MD


June 26, 2014

Editor's Note: While on site at the International Parkinson and Movement Disorder Society (MDS) 18th International Congress of Parkinson's Disease and Movement Disorders, held in Stockholm, Sweden, June 8-12, 2014, Medscape spoke with Robbert Borgemeester, MD, about his study looking at long-term data on subcutaneous apomorphine in Parkinson disease (PD).[1]

Medscape: Can you give us some background on your study?

Robbert Borgemeester, MD: Our objective was to review the long-term outcomes of subcutaneous apomorphine in PD patients. We performed a retrospective analysis of a Dutch cohort of 125 patients. Apomorphine is a highly effective dopamine agonist.

Medscape: When in the disease course is apomorphine typically used?

Dr. Borgemeester: Typically when levodopa starts to fail and patients develop motor fluctuations. At this point, apomorphine and deep brain stimulation are other treatment options. So it's mostly used in the advanced stages of PD at which point it's relatively effective, as our work shows.

Some of our patients have used apomorphine for over 11 years. There are other retrospective analyses out there, but our cohort differed from others in the literature because our patients had more severe hallucinations. Over 50% of them had a history of hallucinations and over 30% had active hallucinations. Apomorphine significantly improved hallucinations in 15 patients and moderately improved them in another 9 patients; only 3 patients reported worsening of their hallucinations with treatment.

Medscape: So apomorphine treatment might be especially appropriate in PD patients with active hallucinations or other features of psychosis?

Dr. Borgemeester: Yes! We think so.


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