APO-go (apomorphine continuous subcutaneous infusion) / Stada, Kyowa Kirin, Endo, Supernus Pharma - LARVOL DELTA

Real-World Patient Experiences Using Continuous Subcutaneous Apomorphine Infusion (ONAPGOTM) in the United States: (clinicaltrials.gov) - P=N/A | N=120 | Recruiting | Sponsor: Supernus Pharmaceuticals, Inc.

New trial • Real-world evidence • CNS Disorders • Movement Disorders • Parkinson's Disease

Establishing Clinical Education and Patient Support Programs for Continuous Subcutaneous Apomorphine Infusion (CSAI) in the United States (MDS Congress 2025) - " Needs assessment was conducted with U.S. MDS, UK nurses experienced in CSAI therapy, the Apokyn CNN team, and PwPD survey data. The Master Class and CNN programs provide a framework for HCPs, PwPD, and CP to gain confidence and proficiency in using CSAI therapy and may contribute to improved knowledge and patient adherence. Learnings from these programs can be used to enhance healthcare delivery for PwPD."

Clinical • CNS Disorders • Movement Disorders

European Experience with Long-term Continuous Subcutaneous Apomorphine Infusions at Higher Doses (MDS Congress 2025) - "CSAI is an important option for patients with advancing PD. The data suggest patients may benefit from, and can be safely maintained on, CSAI doses ≥6mg/h or ≥100 mg/d. These EU data extend the safety information about higher daily doses and higher infusion rates of apomorphine."

CNS Disorders • Movement Disorders • Parkinson's Disease

Continuous Subcutaneous Apomorphine Infusion (CSAI) Reduces OFF Periods and Extends Periods of GOOD ON Time: Heatmap Analysis of the TOLEDO Study (MDS Congress 2025) - "In addition to overall reduction in OFF time and increased GOOD ON time, this analysis of TOLEDO study data showed that participants maintained on CSAI therapy exhibited more prolonged periods of GOOD ON time uninterrupted by OFF episodes relative to placebo. These changes in the pattern of motor states are accompanied by increased patient perceptions of improvement."

CNS Disorders • Movement Disorders • Parkinson's Disease

SUBCUTANEOUS APOMORPHINE INFUSION EFFECTS ON OFF TIME AND MOTOR SYMPTOMS IN INDIVIDUALS WITH PARKINSON'S DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS (WCN 2025) - "Continuous subcutaneous Apomorphine infusion offers a less invasive alternative to device-aided therapies such as deep brain stimulation and Levodopa-Carbidopa intestinal gel. This systematic review supports the efficacy of Apomorphine infusion in reducing OFF time and improving motor symptoms in individuals with advanced PD. Apomorphine infusion represents a treatment option, particularly for patients ineligible for surgical interventions."

Retrospective data • Review • CNS Disorders • Movement Disorders • Parkinson's Disease

Real-World EU Data Suggest Safety of High-Dose Apomorphine Infusion in Parkinson Disease (NeurologyLive) - "Long-term, higher-dose continuous subcutaneous apomorphine infusion (CSAI; Onapgo; Supernus Pharmaceuticals) appears to be safe and tolerable for patients with advanced Parkinson disease (PD), according to data from a real-world European-based study.... The therapy’s safety profile remained consistent with prior studies of lower-dose infusions. A total of 41.3% of patients reported at least 1 adverse event (AE), the majority of which were infusion site reactions. Skin nodules were the most frequently reported AE, occurring in 38.1% of patients (n = 24). Other reported events included hallucinations (4.8%) and hypotension (1.6%). Importantly, no reported AEs led to dose reductions or discontinuation of high-dose CSAI."

Real-world • Parkinson's Disease

Improving the Study of Impulse Control Disorders in CSAI-Treated Parkinson's Disease: Methodological and Interdisciplinary Directions. (PubMed, Mov Disord Clin Pract) - No abstract available

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Reply: "Improving the Study of Impulse Control Disorders in CSAI-Treated Parkinson's Disease: Methodological and Interdisciplinary Directions". (PubMed, Mov Disord Clin Pract) - No abstract available

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Clinical Impact of Switching from Subcutaneous Apomorphine to Foslevodopa/Foscarbidopa in Advanced Parkinson's Disease: A Real-World Observational Study (FOSAPO). (PubMed, Mov Disord Clin Pract) - "Switching from CSAI to CSFLI is feasible, effective, and well tolerated. Behavioral changes observed in two cases underline the need for clinical awareness when treating patients with subtle cognitive vulnerability."

Journal • Observational data • Real-world evidence • CNS Disorders • Movement Disorders • Parkinson's Disease • Psychiatry

Cost of Quality of Life in Advanced Parkinson's Disease: Efficient Strategies for Disease Assessment. (PubMed, Rev Neurol) - "These results provide additional information on the efficiency of treatments that should inform decision-making in the management of advanced Parkinson's disease, thus enabling better resource management."

HEOR • Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Cognitive outcomes of infusion therapies in Parkinson's disease: A comprehensive systematic review. (PubMed, Parkinsonism Relat Disord) - "The cognitive effects of device-aided treatments in PD show substantial variability, and their impact on cognitive function, processing speed, attention, and memory is inconsistent, with some studies reporting impairments and others indicating stability or slight improvements. The heterogeneity in study designs, neuropsychological assessments and coexisting vascular and amyloid pathology further complicates interpretation, underscoring the need for more controlled investigations."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Movement Disorders • Parkinson's Disease

Profile of People With Parkinson's Disease Treated With a Device-Aided Therapy in Spain. A Comparative Multicenter Observational Study. (PubMed, Mov Disord Clin Pract) - "Subcutaneous therapies and DBS were the most frequent DATs (86.9%) implemented in Spain in 2024. Profile differences were detected between DAT types."

Journal • Observational data • CNS Disorders • Movement Disorders • Parkinson's Disease

Subcutaneous Apomorphine Infusion Initiation Is Associated with Impulse Control Disorder Attenuation in Advanced Parkinson's Disease Patients: Insights from the French NS-Park Cohort. (PubMed, Mov Disord Clin Pract) - "The presented findings of our real-life cohort suggest that ICD tend to improve following CSAI initiation in patients with PD, likely due to a reduction of oral DA or the effect of continuous dopaminergic stimulation provided by the pump. While this observation is clinically relevant, it should be interpreted with caution given the study's observational design and the limitations inherent to using MDS-UPDRS sub-items for ICD assessment."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Onapgo - an apomorphine subcutaneous infusion for Parkinson's disease. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Reduction in Parkinson OFF Episodes Through Subcutaneous Apomorphine Infusion Leads to Doubling of Good ON Time (NeurologyLive) - P3 | N=99 | INFUS-ON (NCT02339064) | Sponsor: MDD US Operations, LLC a subsidiary of Supernus Pharmaceuticals | "A post-hoc analysis of patient diary data from the phase 3 InfusON trial (NCT02339064) showed that treatment with continuous subcutaneous apomorphine infusion...led to a significant reduction of daily OFF episodes in patients with Parkinson disease (PD), which more than doubled the amount of uninterrupted good ON time each day..In the 12-week study, patients on CSAI demonstrated an average total daily good ON time increase of 42%, and total daily OFF time decrease by 39%. From baseline to week 12, the longest duration of uninterrupted good ON time went from 4.4 hours to 9.6 hours (n = 65). In addition, the total daily duration good ON time went from 9.3 hours to 12 hours, while the totally daily duration of OFF time decreased from 6.6 hours to 3.5 hours....Presented at the 2025 Advanced Therapeutics in Movement and Related Disorders (ATMRD) Congress, held June..."

P3 data • Parkinson's Disease

INFUS-ON: Infusion of Apomorphine: Long-term Safety Study (clinicaltrials.gov) - P3 | N=99 | Active, not recruiting | Sponsor: MDD US Operations, LLC a subsidiary of Supernus Pharmaceuticals | Trial completion date: Dec 2024 ➔ Dec 2025

Trial completion date • CNS Disorders • Movement Disorders • Parkinson's Disease • COMT

Twenty-five-year experience with apomorphine pump in Parkinson's disease: A real-life long-term retrospective tolerance study. (PubMed, J Parkinsons Dis) - "BackgroundContinuous subcutaneous apomorphine infusion (CSAI) is a standard of care treatment in advanced Parkinson's disease (PD) to treat motor fluctuations...About 79.8% patients had AEs, mainly hallucinations (41.3%) and nodules (24.0%). The best discontinuation predictors were CSAI duration and baseline off medication MDS-UPDRS motor score.ConclusionsThese results may help clinicians better select patients, anticipate and manage AEs, and predict CSAI discontinuation."

Journal • Retrospective data • CNS Disorders • Movement Disorders • Parkinson's Disease

No one size fits all approach with apomorphine initiation. (PubMed, Parkinsonism Relat Disord) - "Continuous subcutaneous apomorphine infusion (CSAI) is an important treatment for motor fluctuations in the complex phase of Parkinson's disease (PD)...Complication rates in all approaches appear comparable, although the overall clinical profile and comorbitidities of patients should be taken into account when deciding on the best method of initiation. A flexible approach to CSAI initiation has potential benefits to people with PD in terms of better access."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

A delphi consensus statement about French practical management of continuous apomorphine infusion in patients with Parkinson's disease and motor fluctuations. (PubMed, Parkinsonism Relat Disord) - "We provide patient-tailored recommendations with precise indications for the adjustment of apomorphine, oral therapy and levodopa equivalent dose over time during CSAI initiation, based on distinct patient profiles."

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Apomorphine: past, present and future in Parkinson's disease and beyond. (PubMed, Parkinsonism Relat Disord) - "The year 2025 marks the 180th anniversary of the first documented synthesis of apomorphine, and the first U.S. Food and Drug Administration (FDA) approval of a subcutaneous apomorphine infusion device for advanced Parkinson's disease (SPN-830)...The TOLEDO study, which robustly demonstrated a clinically meaningful reduction in off time (as expected based on decades of clinical experience) has now removed this barrier. Challenges to be addressed moving forward include (1) redefining the place of apomorphine in the PD treatment paradigm (from early use to terminal care), (2) reducing access disparities (availability, cost), (3) improving delivery systems and apomorphine formulations, and (4) expanding clinical use both in and outside of neurological disorders, with already tangible results for atypical Parkinsonian syndromes and disorders of consciousness, and promising perspectives in Alzheimer's disease."

Journal • Alzheimer's Disease • CNS Disorders • Movement Disorders • Parkinson's Disease

Optimizing Device-Aided Therapies in Advanced Parkinson's Disease: A Case Series on Continuous Subcutaneous Apomorphine Infusion in Challenging Scenarios. (PubMed, J Mov Disord) - No abstract available

Journal • CNS Disorders • Movement Disorders • Parkinson's Disease

Protocol to Help Neurologists Manage Subcutaneous Apomorphine Therapy Skin Nodules: Expert Roundtable Recommendations (P7-5.023). (PubMed, Neurology) - "Infusion site reactions, including subdermal nodules, cutaneous erythema, and pruritus/pain, are a common occurrence in patients with Parkinson disease (PD) who are treated with continuous subcutaneous apomorphine infusion (CSAI)...Pahwa has received research support from Ask Bio. Author has nothing to discloseAuthor has nothing to disclose."

Journal • CNS Disorders • Dermatology • Infectious Disease • Movement Disorders • Pain • Parkinson's Disease • Pruritus

Access to and Use of Device-aided Therapies in Parkinson's Disease in France from 2015 to 2021: The PARK-DAT Study (P11-5.011). (PubMed, Neurology) - "Device-aided therapies (DAT), which include deep brain stimulation (DBS), levodopa-carbidopa intestinal gel (LCIG) infusion and continuous subcutaneous apomorphine infusion (CSAI), are effective treatment options for advanced PD patients. Mrs. KERBRAT has nothing to disclose."

Journal • Retrospective data • CNS Disorders • Movement Disorders • Parkinson's Disease

Advanced Parkinson's disease and eligibility for device-aided therapies in Morocco: a multicenter cross-sectional study. (PubMed, Neurodegener Dis Manag) - "This study investigates the prevalence and clinical features of advanced Parkinson's disease (APD) in Moroccan patients and evaluates their eligibility for Device-Aided Therapies (DATs), including Deep Brain Stimulation (DBS), Continuous Subcutaneous Apomorphine Infusion (CSAI), and Levodopa-Carbidopa Intestinal Gel infusion (LCIG). Although many Moroccan patients qualify for DATs, their use is minimal. Addressing access barriers is crucial to improve outcomes."

Journal • Observational data • CNS Disorders • Mental Retardation • Movement Disorders • Parkinson's Disease • Psychiatry • REM Sleep Behavior Disorder • Sleep Disorder

Real-world experience with continuous subcutaneous foslevodopa/foscarbidopa infusion: insights and recommendations. (PubMed, J Neural Transm (Vienna)) - "Traditional advanced therapies in Parkinson's disease (PD) with motor fluctuations and dyskinesias like continuous apomorphine infusion (CSAI), levodopa-carbidopa intestinal gel (LCIG), levodopa-carbidopa entacapone intestinal gel (LECIG), or deep brain stimulation (DBS) have played a central role in managing therapy-related complications. Recommendations are presented on how to prevent and manage these adverse effects to maximize patient compliance and therapeutic success. Additionally, the paper examines strategies for optimizing concurrent oral medications when combined with CSFLI, providing guidance on balancing pump infusion with necessary adjunctive oral treatments."

Journal • Real-world evidence • CNS Disorders • Movement Disorders • Parkinson's Disease