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Euro I nf: A M ulticenter C omparative O bservational S tudy of A pomorphine and L evodopa I nfusion in P arkinson's D isease
Author(s) -
MartinezMartin Pablo,
Reddy Prashanth,
Katzenschlager Regina,
Antonini Angelo,
Todorova Antoniya,
Odin Per,
Henriksen Tove,
Martin Anne,
Calandrella Daniela,
Rizos Alexandra,
Bryndum Narissah,
Glad Arne,
Dafsari Haidar Salimi,
Timmermann Lars,
Ebersbach Georg,
Kramberger Milica G.,
Samuel Michael,
Wenzel Karoline,
Tomantschger Volker,
Storch Alexander,
Reichmann Heinz,
Pirtosek Zvezdan,
Trost Maja,
Svenningsson Per,
Palhagen Sven,
Volkmann Jens,
Chaudhuri K. Ray
Publication year - 2015
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26067
Subject(s) - interquartile range , medicine , parkinson's disease , adverse effect , quality of life (healthcare) , anesthesia , disease , nursing
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. © 2014 International Parkinson and Movement Disorder Society