Objective: A clinical audit of apomorphine pumps – The Indian experience.
Background: Continuous dopaminergic therapy remains crucial in the management of moderately advanced Parkinson’s disease (PD). Recent introduction of apomorphine in India has given a perspective to understand the pattern of responses and logistics issues in Indian patients.
Method: Clinical audit of case records of subjects with Parkinson’s disease, who were on apomorphine pumps between May 2019 to January 2020.
Results: Fifteen PD subjects (M:F-8:7) with mean duration of symptoms of 130±16months (Range:48-252months) were on apomorphine pump therapy. The mean duration of follow up was 4±3.5 months (range: 1week to 9months) with an apomorphine pump. All the patients showed good subjective improvement in ON periods and a reduction in motor fluctuations. Clinical adverse effect noted included subcutaneous nodules (n-13), nausea (n-1), Hypersexuality (n-1), Weight loss (n-3), purpuric patch (n-1), and drowsiness (n-1). Subcutaneous nodules were non-severe and would disappear over 48-72 hrs. Nausea was successfully suppressed with domperidone. 6/15 discontinued therapy and reason included: Cost (n=2), Dyskinesia (n=1), Lack of social support (n=1), significant weight loss (n=1), Hallucinations and cost of therapy (n=1). Weight loss (>2kgs) was another feature noted in 3 /15 patients with one discontinuing due to the same reason. The main limitation noted was that of suboptimal utilization of apomorphine pumps by the subjects to reduce the cost burden either by reduced duration of pump utilization or suboptimal dosage of therapy.
Conclusion: Apomorphine pumps does give good clinical and subjective benefits with overall improvement of quality of life in Indian PD subjects by reduction of motor fluctuations and significantly improved ON periods. The side effects profile was similar to other studies, however, weight loss was one of the newer features noted in our patients.
To cite this abstract in AMA style:
D. Hoskere Sreenivasa, R. Jayachandran, R. Seetharam, R. Iyer, P. Kukkle. The Indian Experience of Continuous Dopaminergic therapy with Apomorphine in Parkinson’s Disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/the-indian-experience-of-continuous-dopaminergic-therapy-with-apomorphine-in-parkinsons-disease/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-indian-experience-of-continuous-dopaminergic-therapy-with-apomorphine-in-parkinsons-disease/