Living Up to the Gold Standard in Parkinson Disease: Jennifer S. Hui, MD

“In general, the development of on-demand therapies can be quite groundbreaking in the overall treatment of Parkinson disease. Previously, we’ve really relied on the scheduled dosing of medicine…once per day, three times per day—in the case of levodopa sometimes 10 times per day. So the development of on-demand therapies really changes the landscape.”

At the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, Jennifer S. Hui, MD, assistant professor of neurology, Keck School of Medicine, University of Southern California, presented data from a study of the on-demand Parkinson disease (PD) agent sublingual apomorphine (Kynmobi; Sunovion). The data suggested that when patients were administered the treatment, they had greater motor improvement and a higher rate of responders at earlier time points compared to levodopa—the gold standard for PD.

According to Hui and her co-investigators, the data further support the use of sublingual apomorphine in patients with a delayed ON response to levodopa. All told, the predose mean Movement Disorder Society Unified Parkinson’s Disease Rating Scale 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).

To find out more about the impact that on-demand therapies have had on treating PD and if they live up to the gold standard set by levodopa, NeurologyLive caught up with Hui. She offered her perspective on the data, and how these agents have improved the approach to the somewhat unpredictable nature of OFF time. Hui also detailed what else she’d like to see explored regarding sublingual apomorphine’s use in this population.

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