![]() ![]() Apomorphine was associated with more frequent dizziness, found in 7 (15%) participants compared with none in the placebo group.Īdditional findings from the study showed that night-time apomorphine led to greater increase in percentage of sleep stage N2 (6.59% 95% CI, 0.96-12.23 P =. 36).Īpomorphine infusion was also found to be safe, as 54% (n = 25) of those on active therapy reported adverse events (AEs) vs 37% (n = 17) of those on placebo. On morning awakening, compared with the placebo period, the apomorphine period was associated with an improvement in motor condition, as demonstrated by change in Likert scale score (–0.57 95% CI, –0.98 to –0.16 P =. 011) and self-estimated clinical global impression of sleep quality (change in CGI score, 1.40 95% CI, 0.62-2.19 P =. ![]() The apomorphine treatment period was also associated with greater change in ISI score (treatment effect, –2.23 95% CI, –3.83 to –0.64 P =. In terms of individual PDSS grouped-item scores, apomorphine outperformed placebo for the items "overall quality of night’s sleep" (1.63 95% CI, 0.49-2.77 P =. Between the 2 treatment groups, change in PDSS score was greater in those on night-time apomorphine infusion than placebo (treatment effect, 9.95 95% CI, 0.88-19.03 P =. During the washout period, the dose was gradually reduced over 3 nights, and patients remained free of medication for the following 14 nights.Īmong the cohort, 91% (n = 42) completed the 2 medication periods. Each treatment period consisted of a 10-night titration phase followed by a 7-night fixed-dose phase. There were 2 treatment periods separated by a washout period, then crossover to the other intervention. The study, which spanned 11 expert centers in France, enrolled 46 patients aged 35 to 80 years with fluctuating PD and moderate to severe insomnia, defined by scores of at least 15 on Insomnia Severity Index (ISI). "Our study supports the concept of continuous dop-aminergic stimulation, not only during the day but also at night, in patients with advanced Parkinson’s disease." "Night-time administration could render apomorphine infusion more acceptable (compared with a 24-h infusion) because patients will not have to deal with the device-related constraints during the daytime," lead investigator Valeria Cochen De Cock, MD, professor of sleep and neurology, Beau Soleil Clinic, and colleagues wrote. Recently published findings in Lancet Neurology from a placebo-controlled study (NCT02940912)showed that night-time subcutaneous apomorphine infusion (Orkyn Aguettant Pharma) for up to 5 mg/h is safe and improves Parkinson disease (PD)-related insomnia, as demonstrated by scores on Parkinson’s Disease Sleep Scale (PDSS) scores. ![]()
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