Apomorphine Infusion Offers Hope for Reducing “OFF” Time in Parkinson’s

A new analysis from the InfusON phase 3 trial shows that continuous subcutaneous apomorphine infusion (CSAI)—marketed as Onapgo—can significantly reduce “OFF” episodes, the times when Parkinson’s medication isn’t working well and symptoms return. ⏱️ More “Good” Time, Less “OFF” Time Over the 12-week trial: Daily “good ON” time (when symptoms are well-controlled) increased by 42% Daily “OFF” time decreased by 39% Longest stretch of uninterrupted ON time more than doubled from 4.4 hours to 9.6 hours Total OFF episodes dropped from 4.5 to 2.8 per day 📊 Real-World Tracking with Patient Diaries Using 24-hour patient diary “heat maps,” researchers closely followed symptom changes. Of the 99 participants, 65 had complete data by week 12. Almost all patients were already on levodopa, and many also used dopamine agonists, MAO-B inhibitors, or COMT inhibitors. Participants’ Perspective: It Helped By week 12: 97% reported feeling improved 75% felt “much” or “very much” improved Even though dyskinesia (involuntary movements) was a common side effect, fewer participants experienced troublesome dyskinesia by the end of the study. ⚠️ Side Effects and Safety The most common side effects were: Infusion site nodules Dyskinesia Nausea Although 33.3% of participants stopped treatment due to side effects, the nodules were generally mild to moderate and not the main reason for stopping. 🔁 Long-Term Benefits Continue Data from the InfusON open-label extension and earlier TOLEDO study support long-term gains: OFF time was reduced by up to 2.8 hours/day during titration ON time without dyskinesia increased by 43% In the TOLEDO study, patients had a 3.66-hour reduction in OFF time and 3.31-hour gain in ON time by week 64 🌟 What This Means For people living with Parkinson’s and their caregivers, CSAI may offer a non-surgical, flexible option to manage motor fluctuations and reclaim more time each day with fewer symptoms. While side effects are possible, many found the benefits meaningful—leading to more symptom-free hours and better quality of life.