Night‐Time Apomorphine Infusion: Who Are the Best Candidates?

BACKGROUND: We recently demonstrated in a randomized controlled trial (APOMORPHEE, NCT02940912) that night‐time only subcutaneous apomorphine infusion improves sleep disturbances and insomnia in patients with advanced Parkinson's disease and moderate to severe insomnia. OBJECTIVES: To identify the best candidates for receiving night‐time only subcutaneous apomorphine infusion in routine care. METHODS: In this post‐hoc analysis of APOMORPHEE, we compared the characteristics of patients according to whether they chose to continue night‐time only subcutaneous apomorphine infusion at the end of the study period or not. RESULTS: Half of the patients (22/42) chose to continue the treatment. Off duration (day or night), painful Off dystonia, and insomnia severity at baseline were associated with night‐time only apomorphine continuation. Multivariate analysis retained only Off duration as an independent predictor of continuation. CONCLUSIONS: The best candidates for night‐time only apomorphine are patients with severe and prolonged Off periods (day or night) and severe insomnia.