MDS 2023 | Clinic vs home dose optimisation of apomorphine sublingual film in Parkinson’s disease

Stuart Isaacson, MD, Director of the Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, explores the challenges of orally administering levodopa as a treatment for Parkinson’s disease due to gastric and esophageal dysmotility. This delay in drug delivery to the intestines leads to variability in the onset of benefit for each dose. In search of a non-gastrointestinal absorbed alternative, Dr Isaacson discusses the use of subcutaneous infusion, inhaled levodopa, and the upcoming therapy of apomorphine sublingual film. The optimal dose of apomorphine was determined in clinical trials by testing various milligram doses until a full-on response was achieved within 30 minutes. A study comparing in-clinic and home titration showed comparable tolerability and adverse event rates, highlighting the value of both approaches for clinicians and patients. This interview took place at the 2023 International Congress of Parkinson’s Disease and Movement Disorders in Copenhagen, Denmark.

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