New study supports CSAI as a viable option for Parkinson’s disease motor symptom control

Continuous subcutaneous apomorphine infusion (CSAI) is an effective treatment for reducing OFF time and increasing Good ON time in patients with Parkinson’s disease who do not respond adequately to oral therapies, according to a study.

An open-label study included 99 patients with Parkinson’s disease who experienced at least 3 hours of daily OFF time despite optimized levodopa therapy and prior adjunctive treatments.

CSAI was initiated with a low dose followed by titration to achieve optimal efficacy. After the titration phase, patients entered a 52-week maintenance period. The results showed significant improvements in motor fluctuations, with a reduction in OFF time by an average of 3 hours per day by week 12, accompanied by a corresponding increase of 3.1 hours in Good ON time. By the end of week 12, 68% of participants reported substantial improvement in their symptoms, and 62% had at least a 2-hour reduction in OFF time. In addition, oral levodopa doses were reduced by an average of 198 mg/day.

Treatment-related side effects included infusion site reactions, dyskinesia, nausea, and somnolence, with the majority occurring during the titration phase. These improvements were maintained through week 52.

Reference
Isaacson SH, Espay AJ, Pahwa R, et al; InfusON Study Group. Continuous, subcutaneous apomorphine infusion for Parkinson disease motor fluctuations: Results from the phase 3, long-term, open-label United States InfusON study. J Parkinsons Dis. 2025;1877718X241310727. doi: 10.1177/1877718X241310727. Epub ahead of print. PMID: 39973510.