Indikationsstellung für invasive medikamentöse Therapien

G. A. Fuchs; R. Hilker; M. Hahne; M. Oechsner; H. Reichmann

doi:10.1055/s-0031-1299773

Aktuelle Neurologie, Inhaltsverzeichnis

Aktuelle Neurologie 2011; 38(10): 538-543
DOI: 10.1055/s-0031-1299773

Workshop

Indikationsstellung für invasive medikamentöse Therapien

Subcutaneous Apomorphine and Duodopa Infusion Therapy for Advanced Parkinson’s Disease

G. A. Fuchs

¹Parkinson-Klinik Wolfach

,

R. Hilker

²Klinik für Neurologie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt a. M.

,

M. Hahne

³Neurologische Klinik, Bad Neustadt/Saale

,

M. Oechsner

⁴HELIOS Klinik Zihlschacht, Neurologisches Rehabilitations Zentrum, Zihlschacht, Schweiz

,

H. Reichmann

⁵Klinik und Poliklinik für Neurologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden

› Institutsangaben

Abstract

Zusammenfassung

Im Verlauf der Langzeitbehandlung des idiopathischen Parkinson-Syndroms entwickeln sich Wirkfluktuationen und Dyskinesien, aber auch nicht-motorische Störungen (autonome Dysfunktionen, psychiatrische Störungen), die sich mit den oralen Kombinationstherapien zunehmend schlechter ausgleichen lassen. Mit der kontinuierlichen subcutanen Apomorphin-Gabe und der duodenalen L-Dopa-Infusionstherapie (Duodopa-Pumpe) stehen 2 medikamentöse invasive, aber auch ökonomisch aufwändige alternative Therapieoptionen zur Verfügung. Nachfolgend werden die Differenzialindikationen beider Verfahren und ihr klinischer Stellenwert diskutiert.

Abstract

In the advanced stages of Parkinson’s disease, oral pharmacotherapy is often insufficient to obtain stable control of motor symptoms such as wearing-off phenomena, dyskinesias or non-motor symptoms. Invasive therapies like continuous subcutaneous infusion of apomorphine or the duodenal infusion of levodopa are promising options for the treatment of severe response fluctuations. In the present review the differential indications for these medical invasive treatments will be discussed.

Schlüsselwörter

Apomorphin - Duodopa - motorische Wirkfluktuationen - nicht-motorische Störungen - fortgeschrittenes idiopathisches Parkinson-Syndrom

Keywords

apomorphine - duodopa - motor flucutations - non-motor symptoms - advanced Parkinson’s disease

Volltext

Referenzen

Literatur
1 Poewe W, Wenning GK. The natural history of Parkinson’s disease. Ann Neurol 1998; 44: S1-S9
2 Schrag A, Quinn N. Dyskinesias and motor fluctuations in Parkinson’s disease. A community-based study. Brain 2000; 123: 2297-2305
3 Olanow CW, Obeso JA, Stocchi F. Continuous dopamine-receptor treatment of Parkinson’s disease: scientific rationale and clinical implications. Lancet Neurol 2006; 5: 677-687
4 2. Deutschsprachiges Forum zur Therapie des fortgeschrittenen Morbus Parkinson. Kontinuierliche dopaminerge Stimulation beim fortgeschrittenen Morbus Parkinson. Hamburg, 29. Januar 2010
5 Schrag A, Jahanshahi M, Quinn N. How does Parkinson’s disease affect quality of life? A comparison with quality of life in the general population. Mov Disord 2000; 15: 1112-1118
6 Defer GL, Widner H, Marié RM et al. Core assessment program for surgical interventional therapies in Parkinson’s disease (CAPSIT-PD). Mov Disord 1999; 14: 572-584
7 Diener H, Putzki N, Berlit P et al. Leitlinien für die Diagnostik und Therapie in der Neurologie. 4. überarbeitete Auflage ed. Stuttgart: Georg Thieme Verlag; 2008
8 Ebersbach G, Hilker R. 1. Drug pumps and deep brain stimulation in therapy for Parkinson’s disease – Which therapy for which patients?. Akt Neurol 2011; 38 (Suppl S1) S39-S42
9 Odin P, Honig H. Apomorphin- und Duodopa-Pumpentherapie bei Parkinson-Krankheit – Langzeiterfahrung und Vergleich. Psychopharmakotherapie, Sonderdruck 2007; 14: 96-100
10 Manson AJ, Turner K, Lees AJ. Apomorphine monotherapy in the treatment of refractory motor complications of Parlinson’s disease: longterm follow-up study of 64 patients. Mov Disord 2002; 17: 1235-1241
11 Reuter I. Nocturnal subcutaneous apomorphine infusion in Parkinson’s disease and restless legs syndrome. Acta Neurol Scand 1999; 100: 163-167
12 Factor SA, Brown DL, Molho ES. Subcutaneous apomorphine injections as a treatment for intractable pain in Parkinson’s disease. Mov Disord 2000; 15: 167-169
13 Di Rosa AE. Continuous apomorphine infusion and neuropsychiatric disorders: a controlled study in patients with advanced Parkinson’s disease. Neurol Sci 2003; 24: 174-175
14 Garcia Ruiz PJ. Nocturnal subcutaneous apomorphine infusion for severe insomnia in Parkinson’s disease. Mov Disord 2006; 21: 727-728
15 Ceballos-Baumann A. Continuous subcutaneous infusion therapy with the apomorphine pump. Akt Neurol 2011; (Suppl S1) S17-S26
16 Chaudhuri KR, Critchley Abott RJ. et al. Subcutaneous apomorphine for on-off oscillations in Parkinson’s disease. Lancet 1988; 2: 1260
17 Hughes AJ, Bishop S, Kleedorfer B et al. Subcutaneous apomorphine in Parkinson’s disease: response to chronic administration for up to five years. Mov Disord 1993; 8: 165-170
18 Kanovsky P, Kubova D, Bares M et al. Levodopa-induced dyskinesias and continuous subcutaneous infusions of apomorphine: results of a two-year, prospective follow-up. Mov Disord 2002; 17: 188-191
19 Katzenschlager R, Hughes A, Evans A et al. Continuous subcutaneous apomorphine therapy improves dyskinesias in Parkinson’s disease: A prospective study using single-dose challenges. Mov Disord 2005; 20: 151-157
20 Garcia Ruiz PJ, Sesar Ignacio A, Ares Pensedo B et al. Efficacy of long-term continuous apomorphine infusion in advanced Parkinson’s disease with motor fluctuations: a multicenter study. Mov Disord 2008; 23: 1130-1136
21 Naidu Y, Logishetty K, Martin A et al. Efficacy of apomorphine infusion on mood and depression aspects of non-motor symptoms in advanced Parkinson’s disease. Park Rel Disord 2009; 15 (Suppl S2) S130 (P2.149)
22 Chaudhuri KR, Abott RJ, Millac PA. Subcutaneous apomorphine for parkinsonian patients with psychiatric side effects on oral treatment. J Neurol Neurosurg Psychiatry 1990; 54: 372-373
23 Ellis C. Use of apomorphine in parkinsonian patients with neuropsychiatric complications to oral treatment. Parkinsonism and Related disorders 1997; 3 (02) 103-107
24 Pietz K. Subcutaneous apomorphine in late stage Parkinson’s disease: A long-term follow-up. J Neurol Neurosurg Psychiatry 1998; 65: 709-716
25 Hagell P, Odin P, Shing M. Apomorphine bei Morbus Parkinson. 1. Auflage, ed. Bremen: UNI-MED-Verlag; 2005
26 Martinez-Martin P, Todorova A, Henriksen T et al. The motor and nonmotor efficacy of subcutaneous apomorphine infusion in chronic advanced PD compared to Parkinson’s patients on conventional therapy. A “real life” study. Mov Disord 2010; 25 (Suppl 2) S421
27 Honig H, Odin P, Chaudhuri KR. Effect of apomorphine on non-motor symptoms in Parkinson’s disease. Akt Neurol 2011; 38 (Suppl S1) S34-S38
28 O’Sullivan JD, Hughes AJ. Apomorphine induced penile erections in Parkinson’s disease. Mov Disord 1998; 13: 536-539
29 Dula E, Bukofzer S Perdok et al. Double blind crossover comparison of 3 mg apomorphine SL with placebo and with 4 mg apomorphine SL in male erectile dysfunction. Eur Urol 2001; 39: 558-564
30 Klos KJ. Pathological hypersexuality predominantly linked to adjuvant dopamine agonist therapy in Parkinson’s disease and multiple system atrophy. Park Relat Disord 2005; 11: 381-386
31 Homann CN, Wenzel K, Suppan K et al. Sleep attacks in patients taking dopamine agonists: review. BMJ. 2002 324. 1483-1487
32 O’Sullivan JD, Lees AJ. Use of apomorphine in Parkinson’s disease. Hosp Med 1999; 60: 816-820
33 Lees AJ, Richardson C, Turner K. Treatment of Parkinson’s disease with apomorphine. Shared guidelines. 3^rd edition London: UCL Hospitals NHS Trust; 1998
34 Todd A, James CA. Apomorphine nodules in Parkinson’s disease: best practice considerations. Br J Community Nurs 2008; 13: 457-463
35 Poltawski L, Edwards H, Todd A et al. Ultrasound treatment of cutaneous side-effects of infused apomorphine: a randomized controlled pilot study. Mov Disord 2009; 24: 115-118
36 Blickpunkt Medizin . 50 Jahre L-Dopa: Von der Tablette zur duodenalen Infusion; 3. Deutschsprachiges Forum zur Therapie des fortgeschrittenen Morbus Parkinson, Innsbruck, 28. Januar 2011. Akt Neurol 2011;
37 Katzenschlager R, Hughes A, Evans A et al. Continuous subcutaneous apomorphine therapy improves dyskinesias in Parkinson’s disease: a prospective study using single-dose challenges. Mov Disord 2005; 20: 151-157
38 Antonini A, Isaias IU, Canesi M et al. Duodenal levodopa infusion for advanced Parkinson’s disease: 12-month treatment outcome. Mov Disord 2007; 22: 1145-1149
39 Antonini A. Continuous dopaminergic stimulation – from theory to clinical practice. Parkinsonism Relat Disord 2007; 13 (Suppl) S24-S28
40 Eggert K, Schrader C, Hahn M et al. Continuous jejunal levodopa infusion in patients with advanced parkinson disease: practical aspects and outcome of motor and non-motor complications. Clin Neuropharmacol 2008; 31: 151-166
41 Honig H, Antonini A, Martinez-Martin P et al. Intrajejunal levodopa infusion in Parkinson’s disease: a pilot multicenter study of effects on non-motor symptoms and quality of life. Mov Disord 2009; 24: 1468-1474
42 Santos-Garcia D, Sanjurjo LF, Macias M et al. Long-term exposure to duodenal levodopa/carbidopa infusion therapy improves quality of life in relation especially to mobility, activities of daily living, and emotional well-being. Acta Neurol Scand 2011;
43 Devos D. Patient profile, indications, efficacy and safety of duodenal levodopa infusion in advanced Parkinson’s disease. Mov Disord 2009; 24: 993-1000
44 Nyholm D, Lewander T, Johansson A et al. Enteral levodopa/carbidopa infusion in advanced Parkinson disease: long-term exposure. Clin Neuropharmacol 2008; 31: 63-73
45 Klostermann F. Benefit from jejunal levodopa in a patient with apomorphine pump. J Neurol 2011; 258: 311-312
46 Nyholm D, Jansson R, Willows T et al. Long-term 24-hour duodenal levodopa infusion – outcome and dose requirements. Neurology 2005; 65: 1506-1507
47 Manca D, Cossu G, Murgia D et al. Reversible encephalopathy and axonal neuropathy in Parkinson’s Disease during duodopa therapy. Mov Disord 2009; 24: 2293-2294
48 Santos-Garcia D, Macias M, Llaneza M et al. Serum vitamin B₁₂ and folate levels in Parkinson’s Disease patients treated with duodenal levodopa infusion. Mov Disord 2011; 26: 558-559
49 Elia A, Dollenz C, Soliveri P et al. Motor features and response to oral levodopa in patients with Parkinson’s Disease under continuous dopaminergic infusion or deep brain stimulation. Euro J Neurol 2011;
50 Hilker R, Antonini A, Odin P. What is the best treatment for fluctuating Parkinson’s Disease: continuous drug delivery or deep brain stimulation of the subthalamic nucleus?. J Neural Transm 2011; 118: 907-914