Parkinson's Disease Clinical Trial
Official title:
Comparison of Continuous and Pulsatile Apomorphine Administration in Parkinson's Disease Complicated by Levodopa-induced Dyskinesia
The purpose of this study is to compare the effects of apomorphine, given by two different methods, to determine how best to manage dyskinesias.
Levodopa is a drug that can be taken by mouth, and improves the symptoms of Parkinson's
disease (PD). However it can eventually cause involuntary movements called dyskinesia and
motor fluctuations—fluctuations in the control of symptoms, often referred to as "off" and
"on." Apomorphine is a drug that works as well as levodopa, but does not work if taken by
mouth.
The purpose of this study is to compare the effects of apomorphine in people with PD who have
levodopa-induced motor fluctuations and dyskinesias. In the trial, researchers will compare
the effects of apomorphine administered by subcutaneous bolus injections (pulsatile) and by
ambulatory infusion pumps (continuous) in 24 people with PD, for 6 months.
After an initial screening, potential participants will undergo a test to verify that they
can tolerate and respond to apomorphine. Those who meet all of the requirements will be
randomized to receive the study drug via injections (shots) using an injector pen or a
portable infusion pump. Apomorphine will be given either continuously using the portable pump
during the waking day or intermittently by injection, for 6 months. The pump will be carried
on a belt and connected by a tube to a small needle under the skin. Injections of apomorphine
under the skin will be self-administered by the participants or administered by friends or
family members using injector pens.
After 6 months, the effects of apomorphine use will be assessed by measuring how the
participants respond to levodopa and by measuring their symptoms during the course of the
study. Participants will be followed initially every week, then biweekly, and then monthly in
an outpatient clinic for 6 months. During this time, they may receive adjustments of
apomorphine doses as well as doses of other antiparkinson medications.
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