Sublingual Apomorphine Efficacy Maintained in Long-Term Study

Individuals with Parkinson disease who used sublingual apomorphine (APL) (Kynmobi; Sunovion, Marlborough, MA) in an open-label extension study (NCT02542696), had twice as much motor improvement compared with people who used levodopa for OFF episodes. Motor improvements with APL occurred more quickly and were more durable than those seen with levodopa as measured with the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III.

The mean motor response with APL vs levodopa 15 minutes after taking the medicine was -13.9 vs -6.7, respectively, and remained higher at 30 minutes (-22.9 vs -16.3). The efficacy of levodopa for improving motor symptoms did not reach the level of APL until 60 minutes when peak response was -24.4). At 15 and 30 minutes, 52% and 88% of individuals taking APL had a response compared with 21% and 65% of those taking levodopa. At 1 hour, response rates were 88% for APL and 92% for levodopa. 

Participants in this study had comparable MDS-UPDRS Part III scores at baseline (APL, 41.9; levodopa 42.2). Individuals taking stable medications to treat their PD who were treated with APL had titration of the drug during OFF periods at sequential office visits. Titration began at 10 mg and was increased by 5 mg at a time to a maximum of 35 mg.

These data were reported at The American Academy of Neurology Virtual Annual Meeting April 17-22, 2021.