Apomorphine Injection Significantly Reduces Time to On in Parkinson Disease


The study included patients with Parkinson disease receiving treatment with levodopa carbidopa who experienced morning akinesia.

Results of an open-label study assessing the effect the subcutaneous apomorphine (Apokyn; US WorldMeds) showed that injection of the drug significantly reduced time-to-on in patients with Parkinson disease who experienced delayed onset of morning levodopa.

The study, which was presented at the 2019 International Congress on Parkinson Disease and Movement Disorders, September 22-26, 2019 in Nice, France, included 112 patients in the safety population and 88 in the full analysis set. Patients enrolled in the study first completed a 7-day levodopa period where they recorded their time-to-on after receiving their morning dose of levodopa. Following the baseline period, patients were titrated to an optimal dose of apomorphine between 2 to 6 mg with concomitant trimethobenzamide therapy.

Patients recorded their time-to-on during a 7-day treatment period in which apomorphine was injected each morning. Difference in time-to-on between the treatment and baseline periods was the primary end point. Secondary end points included change on global impression scales, as well as safety and tolerability.

During the treatment period, patients achieved a mean time-to-on of 23.72 minutes compared with 60.86 minutes during the baseline period (P <.0001). Time-to-on greater than 60 minutes was more often recorded in patients who received only levodopa versus levodopa plus apomorphine (46% vs 7%). In addition, significant improvement in global impression scaled were recorded from levodopa baseline to the apomorphine treatment period (all P <.0001). Patients most commonly reported nausea and dizziness, with most of those discontinuing therapy due to adverse events during the titration phase.

Overall, patients treated with subcutaneous apomorphine injection experienced rapid response time and significant improvements in time-to-on compared with levodopa.

For more coverage of MDS 2019, click here.


Rakhimov F, Sultanov B. Management of akinesia in Parkinson’s disease with apomorphine subcutaneous injection. Presented at: MDS 2019. September 22-26, 2019. Abstract 184.

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