Motor response with apomorphine sublingual film and levodopa in patients with OFF episodes

Aim: Evaluate timing of motor improvement with carbidopa/levodopa (CD/LD) and apomorphine sublingual film (SL-APO) in patients with Parkinson's disease and OFF episodes. Methods: A post hoc pooled analysis from two studies assessed Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) scores and investigator-rated FULL ON. Results: At 15 and 30 min following the prescribed first daily CD/LD dose, mean improvements in MDS-UPDRS-III scores were -6.7 and -16.3, respectively, and FULL ON was achieved by 6.5 and 41.8% of patients. Following an optimized SL-APO dose, mean improvements in MDS-UPDRS-III scores were -13.9 and -22.9, and FULL ON was achieved by 34.7 and 81.0% of patients. Conclusion: Concomitant administration of SL-APO with carbidopa/levodopa may be useful for delayed ON. Tweetable abstractDelayed ON with the first morning dose of levodopa (LD) is common in patients with Parkinson's disease. Apomorphine sublingual film improves motor function at 15 min postdose. Concomitant use with LD may allow for faster onset of improvement when delayed ON occurs.

Automated summary

This study evaluated the timing of motor improvement in Parkinson's disease patients with OFF episodes using carbidopa/levodopa (CD/LD) and apomorphine sublingual film (SL-APO). Results showed that mean improvements in MDS-UPDRS-III scores were -6.7 and -16.3 at 15 and 30 minutes following the first daily CD/LD dose, and FULL ON was achieved by 6.5% and 41.8% of patients, respectively. With an optimized SL-APO dose, mean improvements in MDS-UPDRS-III scores were -13.9 and -22.9, and FULL ON was achieved by 34.7% and 81.0% of patients, respectively. In conclusion, concomitant administration of SL-APO with CD/LD may be beneficial for delayed ON.