Eskalationstherapien bei Morbus Parkinson

Zusammenfassung

Medikamentenpumpen mit Apomorphin subkutan oder mit Levodopa/Carbidopa-Gel jejunal via perkutaner enteralen Gastrostomie (PEG) und die tiefe Hirnstimulation stellen die Eskalationstherapien bei Levodopa-Wirkfluktuationen und Dyskinesien dar, wenn die Optimierungsmöglichkeiten der oralen Medikation erschöpft sind. Bei unterschiedlicher Datenlage und Patientenpräferenzen dieser drei Eskalationstherapien ist die Beratung schwierig. Die Entscheidung muss in einem Abwägungsprozess zusammen mit dem Patienten und den Betreuungspersonen diskutiert werden. Ziel dieses CME-Artikels ist es, Indikationen sowie Vorteile und Nachteile dieser drei Eskalationstherapien bei der Parkinson-Krankheit vorzustellen.

Summary

Medication pumps (subcutaneous apomorphine, jejunal levodopa infusion) and deep brain stimulation are treatment options for levodopa-fluctuations and dyskinesias when best treatment with oral medication fails. There are differences in the evidence and patient preferences of these treatment options. The decision which option to choose has to be taken with the patient and care-givers. The aim of this CME review is to highlight the indications and the pro and cons for the use of the continuous subcutaneous infusion of apomorphine, the duodenal infusion of levodopa and deep brain stimulation.

Schlüsselwörter

Parkinson-Syndrom - Medikamentenpumpen - Apomorphin - Dopaminagonisten - jejunale Levodopa-Infusion - tiefe Hirnstimulation

Keywords

Parkinson’s disease - medication pumps - apomorphine - dopamine agonists - jejunal levodopa infusion

• Literatur

• 1 Schrag A, Quinn N. Dyskinesias and motor fluctuations in Parkinson’s disease. A community-based study. Brain 2000; 123: 2297-305.
• 2 Koller WC, Hutton JT, Tolosa E, Capilldeo R. Immediate-release and controlled-release carbidopa/levodopa in PD: a 5-year randomized multicenter study. Carbidopa/Levodopa Study Group. Neurology 1999; 53 (05) 1012-9.
• 3 Schuepbach WM. et al Neurostimulation for Parkinson’s disease with early motor complications. N Engl J Med 2013; 368 (07) 610-22.
• 4 Eggert K. et al Leitlinien Parkinson-Syndrome – Diagnostik und Therapie. AWMF-Register Nr. 030/010 Klasse: S2k 2012
• 5 http://www.dgn.org/images/red_leitlinien/LL_2015/PDFs_Download/Konsultationsfassung_Idiopathisches_Parkinson-Syndrom/S3LL_iPD_Kurzfassung_DGN.pdf In; 2015
• 6 Foltynie T, Magee C, James C, Webster GJ, Lees AJ, Limousin P. Impact of Duodopa on quality of life in advanced Parkinson’s Disease: A UK Case Series. Parkinsons Dis 2013; 2013: 362908.
• 7 Corsini GU, Del Zompo M, Gessa GL, Mangoni A. Therapeutic efficacy of apomorphine combined with an extracerebral inhibitor of dopamine receptors in Parkinson’s disease. Lancet 1979; 1 8123 954-6.
• 8 Stibe CM, Lees AJ, Kempster PA, Stern GM. Subcutaneous apomorphine in parkinsonian on-off oscillations. Lancet 1988; 1 8582 403-6.
• 9 Poewe W, Wenning GK. Apomorphine: an underutilized therapy for Parkinson’s disease. Mov Disord 2000; 15 (05) 789-94.
• 10 Manson AJ, Hanagasi H, Turner K, Patsalos PN, Carey P, Ratnaraj N, Lees AJ. Intravenous apomorphine therapy in Parkinson’s disease: clinical and pharmacokinetic observations. Brain 2001; 124 (02) 331-40.
• 11 Dewey Jr. RB, Hutton JT, LeWitt PA, Factor SA. A randomized, double-blind, placebo-controlled trial of subcutaneously injected apomorphine for parkinsonian off-state events. Arch Neurol 2001; 58 (09) 1385-92.
• 12 Manson AJ, Turner K, Lees AJ. Apomorphine monotherapy in the treatment of refractory motor complications of Parkinson’s disease: long-term follow-up study of 64 patients. Mov Disord 2002; 17 (06) 1235-41.
• 13 Katzenschlager R. et al Continuous subcutaneous apomorphine therapy improves dyskinesias in Parkinson’s disease: A prospective study using single-dose challenges. Mov Disord 2005; 20: 151-7.
• 14 Tyne HL, Parsons J, Sinnott A, Fox SH, Fletcher NA, Steiger MJ. A 10 year retrospective audit of long-term apomorphine use in Parkinson’s disease. J Neurol 2004; 251 (11) 1370-4.
• 15 Garcia Ruiz PJ. et al Efficacy of long-term continuous subcutaneous apomorphine infusion in advanced Parkinson’s disease with motor fluctuations: a multicenter study. Mov Disord 2008; 23 (08) 1130-6.
• 16 Garcia Ruiz PJ. Nocturnal subcutaneous apomorphine infusion for severe insomnia in Parkinson’s disease. Mov Disord 2006; 21 (05) 727-8.
• 17 De Gaspari D. et al Clinical and neuropsychological follow up at 12 months in patients with complicated Parkinson’s disease treated with subcutaneous apomorphine infusion or deep brain stimulation of the subthalamic nucleus. J Neurol Neurosurg Psychiatry 2006; 77 (04) 450-3.
• 18 Factor SA, Brown DL, Molho ES. Subcutaneous apomorphine injections as a treatment for intractable pain in Parkinson’s disease. Mov Disord 2000; 15 (01) 167-9.
• 19 Reuter I, Ellis CM, Ray Chaudhuri K. Nocturnal subcutaneous apomorphine infusion in Parkinson’s disease and restless legs syndrome. Acta Neurol Scand 1999; 100 (03) 163-7.
• 20 Lefaucheur R, Berthelot L, Senant J, Borden A, Maltete D. Acute genital pain during non-motor fluctuations improved by apomorphine. Mov Disord 2013; 28 (05) 687-8.
• 21 Tison F, Wiart L, Guatterie M, Fouillet N, Lozano V, Henry P, Barat M. Effects of central dopaminergic stimulation by apomorphine on swallowing disorders in Parkinson’s disease. Mov Disord 1996; 11 (06) 729-32.
• 22 Kempster PA, Lees AJ, Crichton P, Frankel JP, Shorvon P. Off-period belching due to a reversible disturbance of oesophageal motility in Parkinson’s disease and its treatment with apomorphine. Mov Disord 1989; 4 (01) 47-52.
• 23 Bailbe M, Bataille B, Paquereau J, Lavazais S, Vandermarcq P, Gil R. [Improvement in swallowing difficulties treated by subcutaneous apomorphine infusion after deep brain stimulation in Parkinson’s disease]. Rev Neurol (Paris) 2004; 160 (03) 352-3.
• 24 Christmas TJ, Kempster PA, Chapple CR, Frankel JP, Lees AJ, Stern GM, Milroy EJ. Role of subcutaneous apomorphine in parkinsonian voiding dysfunction. Lancet 1988; 2 8626–8627 1451-3.
• 25 Edwards LL, Quigley EM, Harned RK, Hofman R, Pfeiffer RF. Defecatory function in Parkinson’s disease: response to apomorphine. Ann Neurol 1993; 33 (05) 490-3.
• 26 Di Rosa AE. et al Continuous apomorphine infusion and neuropsychiatric disorders: a controlled study in patients with advanced Parkinson’s disease. Neurol Sci 2003; 24 (03) 174-5.
• 27 Trenkwalder C. et al Expert Consensus Group report on the use of apomorphine in the treatment of Parkinson’s disease – Clinical practice recommendations. Parkinsonism Relat Disord 2015; 21 (09) 1023-30.
• 28 http://www.bfarm.de/SharedDocs/Risikoinformationen/Pharmakovigilanz/DE/RHB/2014/rhb-domperidon.pdf In; 2014
• 29 Schoffer KL, Henderson RD, O’Maley K, O’Sullivan JD. Nonpharmacological treatment, fludrocortisone, and domperidone for orthostatic hypotension in Parkinson’s disease. Mov Disord 2007; 22 (11) 1543-9.
• 30 Borgemeester RWK, Drent M, vanLaar T. Motor and non-motor outcomes of continuous apomorphine infusion in 125 Parkinson’s disease patients. Parkinsonism Relat Disord 2016; 23: 17-22.
• 31 Sage J, Schuh L, Heikkila R, Duvoisin R. Londterm duodenal infusion sof levodopa for motor fluctuations in parkinsonism. Ann Neurol 1988; 24: 87-89.
• 32 Kurlan R, Rothfield KP, Woodward WR, Nutt JG, Miller C, Lichter D, Shoulson I. Erratic gastric emptying of levodopa may cause ’random’ fluctuations of parkinsonian mobility. Neurology 1988; 38 (03) 419-421.
• 33 Sage JI, Trooskin S, Sonsalla PK, Heikkila R, Duvoisin RC. Long-term duodenal infusion of levodopa for motor fluctuations in parkinsonism. Ann Neurol 1988; 24 (01) 87-89.
• 34 Kurlan R, Rubin AJ, Miller C, Rivera-Calimlim L, Clarke A, Shoulson I. Duodenal delivery of levodopa for on-off fluctuations in parkinsonism: preliminary observations. Ann Neurol 1986; 20 (02) 262-5.
• 35 Sage JI, McHale DM, Sonsalla P, Vitagliano D, Heikkila RE. Continuous levodopa infusions to treat complex dystonia in Parkinson’s disease. Neurology 1989; 39 (07) 888-91.
• 36 Nyholm D. et al Duodenal levodopa infusion monotherapy vs oral polypharmacy in advanced Parkinson disease. Neurology 2005; 64 (02) 216-23.
• 37 Olanow CW. et al Continuous intrajejunal infusion of levodopa-carbidopa intestinal gel for patients with advanced Parkinson’s disease: a randomised, controlled, double-blind, double-dummy study. Lancet Neurol 2014; 13 (02) 141-9.
• 38 Zibetti M. et al Long-term duodenal levodopa infusion in Parkinson’s disease: a 3-year motor and cognitive follow-up study. J Neurol 2013; 260 (01) 105-14.
• 39 Buongiorno M. et al Long-term response to continuous duodenal infusion of levodopa/carbidopa gel in patients with advanced Parkinson disease: The Barcelona registry. Parkinsonism Relat Disord 2015; 21 (08) 871-6.
• 40 Uncini A, Eleopra R, Onofrj M. Polyneuropathy associated with duodenal infusion of levodopa in Parkinson’s disease: features, pathogenesis and management. J Neurol Neurosurg Psychiatry 2015; 86 (05) 490-5.
• 41 Lehnerer SM, Fietzek UM, Messner M, Ceballos-Baumann AO. Subacute peripheral neuropathy under duodopa therapy without cobalamin deficiency and despite supplementation. J Neural Transm (Vienna) 2014; 121 (10) 1269-72.
• 42 Fasano A, Romito LM, Daniele A, Piano C, Zinno M, Bentivoglio AR, Albanese A. Motor and cognitive outcome in patients with Parkinson’s disease 8 years after subthalamic implants. Brain 2010; 133 (09) 2664-76.
• 43 Deuschl G. et al A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006; 355 (09) 896-908.
• 44 Weaver FM. et al Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. Jama 2009; 301 (01) 63-73.
• 45 Smeding HM, Speelman JD, Koning-Haanstra M, Schuurman PR, Nijssen P, van Laar T, Schmand B. Neuropsychological effects of bilateral STN stimulation in Parkinson disease: a controlled study. Neurology 2006; 66 (12) 1830-6.
• 46 Schupbach M. et al Neurosurgery in Parkinson disease: a distressed mind in a repaired body?. Neurology 2006; 66 (12) 1811-6.
• 47 Burkhard PR, Vingerhoets FJ, Berney A, Bogousslavsky J, Villemure JG, Ghika J. Suicide after successful deep brain stimulation for movement disorders. Neurology 2004; 63 (11) 2170-2.
• 48 Funkiewiez A. et al Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2004; 75 (06) 834-9.
• 49 Ceballos-Baumann A, Gündel H. Bewegungsstörungen. In: Henningsen P, Gündel H, Ceballos-Baumann A. (Hrsg.) Neuropsychosomatik. Stuttgart: Schattauer; 2006
• 50 Voon V. et al A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson’s disease. Brain 2008; 131 (10) 2720-8.
• 51 Timmermann L. et al Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson’s disease (the VANTAGE study): a non-randomised, prospective, multicentre, open-label study. Lancet Neurol 2015; 14 (07) 693-701.
• 52 Charles PD, Van Blercom N, Krack P, Lee SL, Xie J, Besson G, Benabid AL, Pollak P. Predictors of effective bilateral subthalamic nucleus stimulation for PD. Neurology 2002; 59 (06) 932-4.
• 53 Volkmann J, Ceballos-Bauman A. Wann ist der richtige Zeitpunkt für eine tiefe Hirnstimulation bei Morbus Parkinson?. Akt Neurologie 2009; 36 (S1) S7-S11.
• 54 Ory-Magne F, Brefel-Courbon C, Simonetta-Moreau M, Fabre N, Lotterie JA, Chaynes P, Berry I, Lazorthes Y, Rascol O. Does ageing influence deep brain stimulation outcomes in Parkinson’s disease?. Mov Disord 2007; 22 (10) 1457-63.
• 55 Derost PP, Ouchchane L, Morand D, Ulla M, Llorca PM, Barget M, Debilly B, Lemaire JJ, Durif F. Is DBS-STN appropriate to treat severe Parkinson disease in an elderly population?. Neurology 2007; 68 (17) 1345-55.
• 56 DeLong MR, Huang KT, Gallis J, Lokhnygina Y, Parente B, Hickey P, Turner DA, Lad SP. Effect of advancing age on outcomes of deep brain stimulation for Parkinson disease. JAMA Neurol 2014; 71 (10) 1290-5.
• 57 Ceballos-Baumann A. et al Subkutane Apomorphin-Dauerinfusion beim fortgeschrittenen Morbus Parkinson mit Wirkfluktuationen. Expertenkonsensus. Thieme Praxis Report 2012; 4 (07) 1-12.