Advantages of Sublingual Apomorphine in Parkinson Disease: Jennifer S. Hui, MD

“Overall, I think [this study] is clinically important in gathering information on how sublingual apomorphine might be used in the context of patients’ regular levodopa dose, knowing that patients’ typical levodopa dose can be taken every 3 to 4 hours. This is a good way to fill in the gaps, if you will, between their ON time.”

A recent study of sublingual apomorphine (Kynmobi; Sunovion) including 384 patients with Parkinson disease who received the treatment or levodopa showed greater motor improvement and a higher rate of responders at earlier time points for the sublingual agent. These data, according to the investigators, including Jennifer S. Hui, MD, further support its use in patients with a delayed ON response to levodopa.

All told, the predose mean Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III scores were comparable (apomorphine, 41.9; levodopa, 42.2), and the mean motor response, respectively, was approximately 2-fold higher 15 minutes postdose for the sublingual agent (–13.9) compared to levodopa (–6.7). It additionally remained higher at 30 minutes (–22.9 vs –16.3, respectively), with the levodopa peak response occurring at 60 minutes (–24.3 vs –24.4, respectively).

Hui, who is an assistant professor of neurology at the Keck School of Medicine at the University of Southern California, spoke with NeurologyLive about her presentation of the data at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22. She shared her insight into the findings, the therapy’s potential advantages for patients with Parkinson disease, including how bypassing the gastrointestinal tract can offer a positive.

For more coverage of AAN 2021, click here.

REFERENCE
Hui J, Fox S, Neeson W, et al. Motor Responses to Apomorphine Sublingual Film Compared With Levodopa in Patients With Parkinson’s Disease and “OFF” Episodes. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22. Abstract P2077