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Apomorphine - pharmacological properties and clinical trials in Parkinson's disease.
Parkinsonism Relat Disord. 2016 12; 33 Suppl 1:S13-S21.PR

Abstract

Apomorphine is often considered an archetypal dopamine agonist used in the treatment of Parkinson's disease (PD). However, it can be clearly differentiated from most other commonly used dopamine agonists on the basis of its pharmacology and on its unique clinical profile. Like levodopa and dopamine, apomorphine acts as a potent, direct and broad spectrum dopamine agonist activating all dopamine receptor subtypes. It also has affinity for serotonin receptors, and α-adrenergic receptors. Apomorphine is usually titrated to a dose that provides an equivalent antiparkinsonian response to that provided by levodopa, and its subcutaneous delivery allows a rapid onset of action, usually within 7-10 min. The mode of apomorphine delivery impacts on its clinical profile so as to provide two very different approaches to therapy in PD. When administered as an acute subcutaneous injection, it induces reliable and rapid relief from OFF periods underscoring its utility as a rescue medication. When given as a subcutaneous infusion, it significantly improves overall daily OFF time and there is also evidence to suggest that, in those patients who replace most or all of their oral drugs with apomorphine infusion, dyskinesia may also improve. In this paper, we review the rich pharmacology of apomorphine and review its efficacy in PD based on data from clinical trials.

Authors+Show Affiliations

Neurodegenerative Diseases Research Group, Institute of Pharmaceutical Sciences, Faculty of Life Science and Medicine, King's College London, London, UK. Electronic address: peter.jenner@kcl.ac.uk.Department of Neurology and Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Danube Hospital, Vienna, Austria. Electronic address: regina.katzenschlager@wienkav.at.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27979722

Citation

Jenner, Peter, and Regina Katzenschlager. "Apomorphine - Pharmacological Properties and Clinical Trials in Parkinson's Disease." Parkinsonism & Related Disorders, vol. 33 Suppl 1, 2016, pp. S13-S21.
Jenner P, Katzenschlager R. Apomorphine - pharmacological properties and clinical trials in Parkinson's disease. Parkinsonism Relat Disord. 2016;33 Suppl 1:S13-S21.
Jenner, P., & Katzenschlager, R. (2016). Apomorphine - pharmacological properties and clinical trials in Parkinson's disease. Parkinsonism & Related Disorders, 33 Suppl 1, S13-S21. https://doi.org/10.1016/j.parkreldis.2016.12.003
Jenner P, Katzenschlager R. Apomorphine - Pharmacological Properties and Clinical Trials in Parkinson's Disease. Parkinsonism Relat Disord. 2016;33 Suppl 1:S13-S21. PubMed PMID: 27979722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Apomorphine - pharmacological properties and clinical trials in Parkinson's disease. AU - Jenner,Peter, AU - Katzenschlager,Regina, Y1 - 2016/12/13/ PY - 2016/07/05/received PY - 2016/11/25/revised PY - 2016/12/05/accepted PY - 2016/12/17/pubmed PY - 2018/2/6/medline PY - 2016/12/17/entrez KW - Apomorphine KW - Clinical trial KW - Parkinson's disease KW - Pharmacokinetics KW - Pharmacology KW - Receptor profile SP - S13 EP - S21 JF - Parkinsonism & related disorders JO - Parkinsonism Relat. Disord. VL - 33 Suppl 1 N2 - Apomorphine is often considered an archetypal dopamine agonist used in the treatment of Parkinson's disease (PD). However, it can be clearly differentiated from most other commonly used dopamine agonists on the basis of its pharmacology and on its unique clinical profile. Like levodopa and dopamine, apomorphine acts as a potent, direct and broad spectrum dopamine agonist activating all dopamine receptor subtypes. It also has affinity for serotonin receptors, and α-adrenergic receptors. Apomorphine is usually titrated to a dose that provides an equivalent antiparkinsonian response to that provided by levodopa, and its subcutaneous delivery allows a rapid onset of action, usually within 7-10 min. The mode of apomorphine delivery impacts on its clinical profile so as to provide two very different approaches to therapy in PD. When administered as an acute subcutaneous injection, it induces reliable and rapid relief from OFF periods underscoring its utility as a rescue medication. When given as a subcutaneous infusion, it significantly improves overall daily OFF time and there is also evidence to suggest that, in those patients who replace most or all of their oral drugs with apomorphine infusion, dyskinesia may also improve. In this paper, we review the rich pharmacology of apomorphine and review its efficacy in PD based on data from clinical trials. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/27979722/Apomorphine___pharmacological_properties_and_clinical_trials_in_Parkinson's_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(16)30471-0 DB - PRIME DP - Unbound Medicine ER -