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

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

Industry Therapeutic Update from Supernus Pharmaceuticals Inc.: Special Delivery: Target more consistent control of motor fluctuations with ONAPGO, continuous apomorphine infusion (AAN 2025) - "Sponsored by Supernus Pharmaceuticals, Inc."

Device-assisted therapies for Parkinson disease. (PubMed, Aust Prescr) - "Device-assisted therapies for Parkinson disease include apomorphine continuous subcutaneous infusion, levodopa continuous intestinal gel infusion, levodopa continuous subcutaneous infusion and deep brain stimulation...Initiation and management require neurologist and multidisciplinary involvement, typically in a specialist movement disorder centre. Primary care clinicians play a crucial role in ongoing support and management for people using these therapies, including monitoring and managing adverse effects and communicating with movement disorder services."

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

Levodopa and dopamine agonist phobia in Parkinson's Disease: - does it really matter? A survey on treatment patterns in Polish tertiary centres. (PubMed, Neurol Neurochir Pol) - "Levodopa remains the gold standard in PD treatment in tertiary movement disorder centres in Poland. Dopamine agonists formed the second most frequently prescribed group of medications; however, the observed low dosages of both levodopa and dopamine agonists may suggest a cautious approach by clinicians. Amantadine and MAO-B inhibitors (mainly rasagiline) constituted important elements of PD pharmacotherapy. The high prevalence of complex polytherapy underlines the complexity of PD management, the cautious use of single medication at high doses, and the need for personalised therapeutic strategies."

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

Continuous, subcutaneous apomorphine infusion for Parkinson disease motor fluctuations: Results from the phase 3, long-term, open-label United States InfusON study. (PubMed, J Parkinsons Dis) - P3 | "This study supports the clinical utility of CSAI to reduce OFF time and increase Good ON time in patients with motor fluctuations inadequately controlled with oral therapy."

Journal • P3 data • CNS Disorders • Dermatology • Movement Disorders • Parkinson's Disease

Assessing Eligibility for Apomorphine Therapy in Parkinson's Disease: The Telemonitoring Potential. (PubMed, Mov Disord Clin Pract) - "Using telemonitoring to determine eligibility for apomorphine therapy might improve evaluation and treatment in patients with PD and, therefore help improve their quality of life."

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

Supernus Announces FDA Approval of ONAPGO (apomorphine hydrochloride) for Parkinson’s Disease (GlobeNewswire) - "Supernus Pharmaceuticals...announced today that the U.S. Food and Drug Administration (FDA) approved ONAPGO (apomorphine hydrochloride) injection, formerly known as SPN-830, as the first and only subcutaneous apomorphine infusion device for the treatment of motor fluctuations in adults with advanced Parkinson’s disease (PD). Supernus will make ONAPGO available in the second quarter of 2025 with a support team of experts, including a robust nurse education program, and access support at launch....The approval is based on results from a Phase 3, 12-week, multicenter, parallel-group, double-blind, randomized, placebo-controlled study (N=107) evaluating the efficacy and safety of ONAPGO."

FDA approval • Launch US • Parkinson's Disease

Satisfaction and Preferences for Infusion Therapies in Advanced Parkinson's Disease-Patient Perspective. (PubMed, Medicina (Kaunas)) - "Background and Objectives: The rapid growth of the number of advanced Parkinson's disease (PD) patients has caused a significant increase in the use of device-aided therapies (DATs), including levodopa-carbidopa intestinal gel (LCIG) and continuous subcutaneous apomorphine infusion (CSAI). Furthermore, significant factors influencing patient preferences included fear of surgery (75% vs. 36.8%, p = 0.043) and concerns about DAT safety (83.3% vs. 47.4%, p = 0.049). LCIG and CSAI therapies offer benefits and disadvantages, with safety concerns and fear of surgery seeming to be decisive in the decision-making process."

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

Long-term effect and reasons for switching and combining device-aided therapies in Parkinson's Disease. (PubMed, Neurol Neurochir Pol) - "Future studies are warranted to address the unresolved issues related to long-term efficacy, side effect profile and switching and combination of DATs in multicentric studies and using advanced analytical approaches such as machine learning."

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

Nocturnal continuous subcutaneous infusion of apomorphine in advanced Parkinson's disease: a series of 37 cases (PubMed, Rev Neurol) - "Continuous infusion of apomorphine during the night was an effective and safe treatment in our series."

Journal • Metastases • Observational data • Retrospective data • CNS Disorders • Hematological Disorders • Movement Disorders • Neuralgia • Pain • Parkinson's Disease • Psychiatry • Sleep Disorder

Gender disparity in access to advanced therapies for patients with Parkinson's disease: a retrospective real-word study. (PubMed, Front Neurol) - "Out of 1,252 patients, 200 (mean age ± SD 71.02 ± 9.70; 72% males; median Hoen Yahr level: 3, minimum 1 maximum 5) were selected for advanced therapies: 133 for Magnetic Resonance guided Focused Ultrasound (MRgFUS) thalamotomy (mean age ± SD 70.0 ± 8.9; 77% males), 49 for Levodopa/Carbidopa Intestinal Gel (LCIG) infusion (mean age ± SD 74.3 ± 11.4; 59% males), 12 for Deep Brain Stimulation (DBS) (mean age ± SD 71.2 ± 6.3; 75% males), and 7 for Continuous Subcutaneous Apomorphine Infusion (CSAI) (mean age ± SD 69.7 ± 5.5; 43% males). Women are less confident in selecting advanced therapies during the natural progression of their disease. Factors accounting for this discrepancy deserve further investigation."

Journal • Metastases • Retrospective data • 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 (MDS Congress 2024) - P3 | "These data support the long-term safety, tolerability, and efficacy of adjunctive CSAI."

CNS Disorders • Parkinson's Disease

Improvement in Uninterrupted Good ON Time and Reduction in OFF Periods with CSAI Treatment (MDS Congress 2024) - P3 | "Objective: Evaluate the effect of continuous subcutaneous apomorphine infusion (CSAI) on daily periods of OFF time and Good ON time (ON without troublesome dyskinesia) in people with Parkinson disease (PD) and motor fluctuations as evidenced by patient home diaries... In this post hoc analysis of InfusON patient diary data, in addition to reducing overall OFF time, CSAI therapy titrated to optimal efficacy reduced patients' daily number of OFF periods and, on average, more than doubled the amount of uninterrupted Good ON time. Heat map analysis"

CNS Disorders • Parkinson's Disease

Overview of Phase 3 Trials of Continuous Subcutaneous Apomorphine Infusion for PD Patients with Motor Fluctuations (MDS Congress 2024) - P3 | "Despite differences in study design, results from both Phase 3 studies showed consistent, reproducible efficacy in reducing OFF time and increasing Good ON time from baseline values that were maintained over at least 1 year. Changes in OFF Time and Good ON Time"

Clinical • P3 data • CNS Disorders • Parkinson's Disease