Place of Continuous Subcutaneous Infusion Systems in Parkinson Disease Management

EP: 1.Off Fluctuations in Parkinson Disease

EP: 2.Adjusting and Changing Treatment Regimens in Parkinson Disease

EP: 3.Recognition of Off Episodes in Parkinson Disease

EP: 4.Conversations About Off Time In Patients With Parkinson Disease

EP: 5.Advanced Treatment Options in Parkinson Disease

EP: 6.Adjunctive Treatments and Apomorphine for Treatment of Parkinson Disease

EP: 7.Continuous Subcutaneous Apomorphine Infusion (CSAI) and TOLEDO Study in Parkinson Disease

EP: 8.CSAI and INFUS-ON Study for Treatment of Parkinson Disease

EP: 9.Continuous Subcutaneous Infusion Systems for Parkinson Disease and Patient Selection Criteria

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EP: 10.Place of Continuous Subcutaneous Infusion Systems in Parkinson Disease Management

EP: 11.Clinical Experience With CSAI for Parkinson Disease

EP: 12.Place of Recent Approvals in Parkinson Disease Management

EP: 13.Patient Conversation and Adoption of CSAI in Clinical Practice

EP: 14.Clinical Nurse Educators, Dosing Titrations to Manage Parkinson Disease

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Placement of Infusion Therapies in Parkinson Disease Management

• Consider after oral medication optimization fails to provide adequate control
• Position before deep brain stimulation (DBS) in treatment algorithm
• Appropriate for patients with medication-responsive symptoms but problematic motor fluctuations
• Viable option when cognitive/psychiatric issues contraindicate DBS
• Can be used as a transitional therapy before considering more invasive options
• Particularly valuable for patients with unpredictable off periods
• May be considered earlier in disease course than traditionally recommended for advanced therapies
• Best implemented with a multidisciplinary team approach (neurology, nursing, pharmacy)
• Should be part of a comprehensive care plan addressing motor and nonmotor symptoms