A new French study has shown that using a continuous injection device to combat the symptoms of Parkinson's disease—similar to insulin pumps for diabetes patients—represents a treatment that provides encouraging long-term results for some who have reached advanced stages of the disease.
One of the study's authors, neurologist Emmanuel Flaman Rose, explained that "quality of life stabilizes, and motor fluctuations (i.e., the alternation of improvement and the return of symptoms) improve after two years" among the relevant patients. However, he clarified that this does not apply to all Parkinson's patients.
He stated that "two cases arise from the progression of the disease; in one, symptoms such as tremors, stiffness, and slowness do not respond to swallowable tablet treatments." In the other case, "treatments remain effective, but with significant daily variations: when people take their pills, they improve. Then, after the effect wears off, their condition deteriorates, and so on. For these patients, continuous treatments represent a good option," the specialist explained.
For this purpose, a device known as the "apomorphine pump" is used, which patients carry around the clock or during the day; it can be placed in their pocket, attached to their belt, or worn around their neck, and it automatically injects the treatment.
Professor Flaman Rose noted that this device "is similar to an insulin pump for diabetes." He explained that "sugar levels can get very high in diabetes, which is then lowered, while in Parkinson's disease, dopamine (a molecule present in the brain) levels are very low and the necessary amount is provided continuously."
He added, "When a patient takes a pill, it causes a sudden spike (in dopamine) in the brain, which then declines, causing fluctuations. However, with continuous treatment, it is much closer to what occurs naturally."
The neurologist, who works at the Pitié-Salpêtrière Hospital in Paris, stated that "the importance of the study lies in the fact that it shows a certain number of patients can benefit from this treatment, which is still limited in use."
Parkinson's is considered a neurodegenerative disease, and as it progresses, the risk of becoming dependent on others increases due to motor and cognitive complications that can lead to dementia.
The researchers monitored the condition of 110 patients in advanced stages over two years who were treated with the apomorphine pump. The study concluded that the treatment was particularly beneficial for patients who had already been experiencing motor fluctuations before starting treatment.
Professor Flaman Rose viewed it as "an excellent result for a neurodegenerative disease; over two years in an advanced stage, we would generally expect the condition to worsen." However, he was keen to clarify for accuracy that "it is not a cure for previously untreated symptoms; rather, it may help avoid fluctuations when another treatment is effective." Additionally, it "does not slow disease progression but only treats symptoms."
Finally, one-third of the patients involved in the study discontinued treatment, "either because side effects emerged, or because it did not achieve the desired results sufficiently, or to test whether it improved patients' sleep, while others wanted to see if it should be used without waiting for the disease to reach an advanced stage."
