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

Continuous subcutaneous apomorphine infusion to improve comfort in advanced degenerative Parkinsonian syndrome patients: a retrospective descriptive study in a home-based setting. (PubMed, Parkinsonism Relat Disord) - "The findings point toward a potential benefit of CSAI delivered through a HaH program on symptom and comfort improvement in advanced PD and MSA patients. This positive effect was suggested in patients facing a life-threatening event compromising the oral route, whether or not they were in the immediate end-of-life phase."

Journal • Retrospective data • CNS Disorders • Movement Disorders • Multiple System Atrophy • Pain • Palliative care • Parkinson's Disease

Oculogyric crisis induced by high-dose apomorphine in a patient with advanced Parkinson's disease. (PubMed, Parkinsonism Relat Disord) - No abstract available

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

Treatment strategies for motor fluctuations in Parkinson's disease: a systematic review of efficacy, functionality, and drug accessibility with a focus on Latin America. (PubMed, Front Pharmacol) - "High-certainty evidence supports the efficacy of extended-release levodopa (IPX066), opicapone, pramipexole, rotigotine, and safinamide in reducing OFF-time, although improvements in functional disability and quality of life were modest or inconsistent. Moderate-certainty evidence supports device-aided therapies, including levodopa-carbidopa intestinal gel (LCIG), subcutaneous foslevodopa-foscarbidopa, and continuous apomorphine infusion, which achieved larger effects on OFF-time and functional outcomes...In contrast, several newer therapies-such as IPX066, opicapone, istradefylline, and foslevodopa-foscarbidopa-were unavailable in most Latin American markets, and price differentials for controlled-release or add-on therapies were often several-fold higher after PPP adjustment...The Latin American region exemplifies these disparities, with limited regulatory availability, heterogeneous pricing, and insufficient inclusion of novel agents in national formularies...."

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

OPTIDOM: Interest of Continuous Subcutaneous Apomorphine in Parkinsonian Patients at the End of Life (clinicaltrials.gov) - P=N/A | N=80 | Not yet recruiting | Sponsor: Centre Hospitalier Régional d'Orléans

New trial • CNS Disorders • Movement Disorders • Parkinson's Disease

Impact of device-aided therapies on quality of life in patients with Parkinson's disease. A comparative multicenter observational study. (PubMed, J Neural Transm (Vienna)) - "No differences in the change of the PDQ-39 total score were detected between both subcutaneous therapies (i.e., foslevodopa/foscarbidopa [fLD/fCD] and continuous subcutaneous apomorphine infusion [CSAI]; p = 0.666) and between subcutaneous and enteral therapies (p = 0.721). Off time, dyskinesia, motor symptoms, and non-motor symptoms improved significantly in the entire cohort. HRQoL improved in PwP after being treated with a DAT."

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

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