期刊名称：Annals of Agricultural and Environmental Medicine
印刷版ISSN：1232-1966
电子版ISSN：1898-2263
出版年度：2019
卷号：26
期号：1
页码：1-5
DOI：10.26444/aaem/99699
出版社：Institute of Agricultural Medicine in Lublin
摘要：Introduction and objective. Continuous subcutaneous apomorphine (APO) treatment is one of the 3 therapeutic options
for advanced Parkinson’s disease (PD), in addition to deep brain stimulation (DBS) and intrajejunal levodopa. Data from
previously performed studies show that few PD patients can achieve APO infusion as monotherapy. The current pilot study
presents the authors’ experience in achieving APO monotherapy.
Materials and method. During the last 2 years, 9 patients with APO were treated in the Department of Neurology of the
Medical University of Lublin; each patient was offered a 5-day duration APO treatment as monotherapy. The main indication
for the APO therapy was advanced PD with motor fluctuations and the patient’s non-agreement for DBS therapy. Mean
age of treated patients – 65.11 years, mean disease duration – 7.67 years, mean Hoehn-Yahr – 2.67, mean L-dopa equivalent
before APO treatment – 1751.11 mg, mean daily dose of apomorphine as monotherapy – 106.11 ± 14.09 mg.
Results. All treated patients managed to achieve APO monotherapy. A statistically significant reduction was found in the
duration of the ‘off’ states in the observed PD patients on APO monotherapy (p<0.05). No significant improvement was
observed in the III motor score of the UPDRS on APO treatment, compared to optimized oral therapy used before APO
treatment.
Conclusions. APO monotherapy can be achieved in advanced PD, and seems to be a good therapeutic option for this
group of patients, especially in that it allows a significant reduction in the off-time which significantly simplifies the drug
regime. Nevertheless, hospital admission with experienced neurologist supervision is recommended when establishing a
PD patient’s APO monotherapy.
