SUBCUTANEOUS APOMORPHINE IN PARKINSONS-DISEASE - RESPONSE TO CHRONIC ADMINISTRATION FOR UP TO 5 YEARS
SUBCUTANEOUS APOMORPHINE IN PARKINSONS-DISEASE - RESPONSE TO CHRONIC ADMINISTRATION FOR UP TO 5 YEARS
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DOI：
10.1002/mds.870080208
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发表时间：
1993-04-01
影响因子：
8.6
通讯作者：
STERN, GM
中科院分区：
文献类型：
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作者：
HUGHES, AJ;BISHOP, S;STERN, GM
71 名患有严重难治性左旋多巴相关开关波动的帕金森病患者通过连续清醒时推注或重复间歇注射的方式皮下注射阿扑吗啡，持续 1-5 年。每日休息时间平均减少约 50%，长期随访中神经精神毒性的发生率仍然较低。尽管日益严重的同期运动障碍和姿势不稳损害了许多患者的长期治疗反应，但没有发现临床上显着的耐受性或治疗效果丧失。尽管存在这些缺点，阿朴吗啡与外周多巴胺受体激动剂多潘立酮联合使用时，在治疗晚期帕金森病方面代表了显着的治疗进展，并且在实验性植入手术之前当然应该考虑。
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.