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

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

Therapies for Advanced Parkinson's Disease in Sweden: A Cost-Effectiveness Analysis Using Real-World Data. (PubMed, Neurol Ther) - "DBS is a cost-effective use of resources in Sweden. However, uncertainty remains regarding long-term symptom control as well as quality of life within specific health states for all device-aided therapies, and further data are needed to fully validate the model projections and provide more insight into areas of future research."

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

Update on Treatments for Parkinson's Disease Motor Fluctuations - An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review. (PubMed, Mov Disord) - "There are several treatment options that can improve motor fluctuations in PD. These recommendations will assist physicians and patients in determining which intervention to use."

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

Protocol to Help Neurologists Manage Subcutaneous Apomorphine Therapy Skin Nodules: Expert Roundtable Recommendations (AAN 2025) - "Objective:We aimed to develop a structured algorithm for the routine clinical evaluation and management of infusion site reactions (ISRs) in patients with PD treated with CSAI.Background: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)...ISRs are common with CSAI therapy, and probably reflect an inflammatory reaction in sensitized patients. Most ISRs resolve spontaneously, but some require evaluation to exclude infection. Simple steps to try to minimize ISRs are proposed."

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

Improvement in Uninterrupted Good ON Time and Reduction in OFF Periods with CSAI Treatment (AAN 2025) - P3 | "Objective:Evaluate the effect of continuous subcutaneous apomorphine infusion (CSAI) on daily OFF time and Good ON time (ON without troublesome dyskinesia) via diaries in people with Parkinson disease (PD) and motor fluctuations.Background:The Phase 3 open-label InfusON study (NCT02339064) showed that, after 12 weeks of maintenance treatment with CSAI, patients' daily OFF time decreased by a mean of ‑3.0 hours with a corresponding increase in Good ON time (+3.1 hours).Design/InfusON enrolled individuals experiencing ≥3 hours of daily OFF time despite optimized therapy...CSAI therapy reduced patients' daily number of OFF periods, reduced overall OFF time, and on average more than doubled longest duration uninterrupted Good ON time."

CNS Disorders • Movement Disorders • Parkinson's Disease

Access to and Use of Device-aided Therapies in Parkinson's Disease in France from 2015 to 2021: The PARK-DAT Study (AAN 2025) - "Objective:The aim of the PARK-DAT study was to measure access to and use of device-aided therapies (DAT) for Parkinson's disease (PD) in France over a period extending from 2015 to 2021, using the French administrative health care database (Système National des Données de Santé /SNDS).Background: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. Unlike in other countries, where the most widely used DAT is DBS (Poland, Norway, Germany) or LCIG (Denmark), the DAT most frequently initiated and used in France between 2015 and 2021 is CSAI, in unprecedented proportions, while the use of DBS is declining. The specific features of the French healthcare system (reimbursement rates, availability of homecare nurse providers) may explain this distribution and the high prevalence..."

CNS Disorders • Movement Disorders • Parkinson's Disease

Continuous Subcutaneous Apomorphine Infusion for Parkinson Disease Motor Fluctuations: Long-term Data from the Ongoing InfusON Extension Study (AAN 2025) - P3 | "These data support the long-term safety, tolerability, and efficacy of adjunctive CSAI."

CNS Disorders • Movement Disorders • Parkinson's Disease

Patient Experiences Initiating Continuous Subcutaneous Apomorphine Infusion (CSAI): An Interview-based Survey of InfusON Study Participants (AAN 2025) - P3 | "Patient experience is a key driver of how long patients remain on therapy. This survey showed that patients quickly adapt and easily incorporate CSAI into their routine. Most patients would recommend CSAI to other people with PD."

Clinical • Interview • CNS Disorders • Movement Disorders • Parkinson's Disease

Industry Therapeutic Update from Supernus Pharmaceuticals, Inc.: Special Delivery: Target more consistent control of motor fluctuations with ONAPGO, continuous apomorphine infusion (AAN 2025) - "The AAN cannot affirm claims pertaining to FDA off-label medication, research use of pre-FDA drugs, or other research information that might be discussed. Industry Therapeutic Updates are industry events."

CNS Disorders • Movement Disorders • Parkinson's Disease