Objective: The aim of this study is to evaluate the feasibility, efficacy and safety of NCSAI administration in patients with Advanced Parkinson disease (APD).
Background: Subcutaneous apomorphine is one of the second line treatments for APD. There are few data about the beneficial effect of NCSAI in non-motor symptoms other than sleep disturbances in APD.
Method: We present an observational, retrospective study, in patients with APD treated with NCSAI in our Hospital from 2011 until 2022. From 117 patients receiving apomorphine, we collected data on 37 patients either treated or currently being treated with NCSAI to assess the indication for nocturnal use, as well as its efficacy and safety, including reasons for withdrawal.
Results: In our cohort, NCSAI was started within a mean time of 7.7 months after the initiation of daytime infusion, and the average treatment duration was 24 months (1-64 months). 50% of patients started NCSAI due to motor complications, 19% because of non-motor, and 31% because of both. The most common non-motor symptoms were fragmentation and disruption of sleep (not REM behavior disorder), neuropathic pain, anxiety, and intense nocturia. Among the 37 patients 20 (54%) continue using NCSAI, 16 (43%) discontinued the infusion, and there is no follow up from 1 (3%). Reasons for treatment withdrawal were: the implantation of deep brain stimulation in 3 patients; 4 due to side effects (serious nodules, dopaminergic psychosis, Coombs + with/without anemia); 1 because of sub-optimal adaption to the device; and 4 due to death unrelated to treatment during the follow up. Only 4 patients finished NCSAI maintaining daytime infusion because of suboptimal adaptation to night time device as the main reason.
Conclusion: In our series, NCSAI has been demonstrated to be a safe and effective tool for managing both motor and non-motor symptoms in APD. More studies are needed to confirm these findings.
To cite this abstract in AMA style:
AK. Vargas Mendoza, B. López López, M. Díaz Castela, J. Molina Gil, P. Zunzunegui Arroyo, A. Criado Antón, ME. Suárez Sanmartín, C. García Fernández. USE OF NIGHT TIME CONTINUOUS SUBCUTANEOUS INFUSION OF APOMORPHINE (NCSAI) IN ADVANCED PARKINSON’S DISEASE: A SERIES OF 37 CASES. [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/use-of-night-time-continuous-subcutaneous-infusion-of-apomorphine-ncsai-in-advanced-parkinsons-disease-a-series-of-37-cases/. Accessed November 21, 2024.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/use-of-night-time-continuous-subcutaneous-infusion-of-apomorphine-ncsai-in-advanced-parkinsons-disease-a-series-of-37-cases/