Sponsored Article

STADA Australia continues to innovate in Parkinson’s Disease with MOVAPO^® pre-filled syringes (PFS)

Parkinson’s Disease is a surprisingly prevalent condition with an estimated 10 million people worldwide and roughly 70,000 Australians (1 in every 340 people) suffering from the condition.¹ It is the second most prevalent neurological condition exceeded only by dementia. It is more common than some cancers including breast, colorectal, lung, ovarian, leukaemia to name a selection.¹ With people living with Parkinson’s Disease for well over 20 years, it places a significant economic burden on the health care system, employees, patients and their carers.¹

Parkinson’s Disease is mainly a clinical diagnosis. However, modern imaging and nuclear techniques can provide supplementary information allowing a precise distinction from differential diagnosis, such as essential tremor or other parkinsonian syndromes. It can provide a more accurate and earlier diagnosis.²

With no cure confirmed, treatments all aim to minimise a patient’s symptoms and side effects, maximise their quality of life and slow the progression of the disease. As with all medications there are benefits and risks and prescribers will evaluate all of these at each stage along the disease continuum.

Oral therapies are the first line of treatment and are effective for most patients in the early stages of the disease (first 2-3 years post the onset of signs and symptoms).³ However, long-term oral levodopa has limitations despite patients taking optimised regimens.³ Motor fluctuations are experienced by up to half of levodopa-treated Parkinson’s Disease patients by 2 years after the start of therapy³ with other studies confirming the emergence of motor complications after 4-6 years, including medically refractory fluctuations and /or dyskinesias.² Over time, regular and/or unpredictable ‘off’ periods negatively impact patients’ daily routines and their overall quality of life.³ Delayed gastric emptying attributable to Parkinson’s Disease can affect absorption of oral medications resulting in gaps of levodopa’s benefits despite regular oral dosing. ^3,4,5 Hence, alternate classes of therapy with different routes of administration may need to be considered.

A second line established approach for treating patients refractory to conventional oral drug therapy is administration of the dopaminergic agonist apomorphine. MOVAPO (apomorphine hydrochloride) pre-filled syringes (PFS) are indicated to reduce the number and severity of ‘off’ phases in patients with Parkinson’s Disease severely disabled by motor fluctuations refractory to conventional therapy. Initiation of therapy with apomorphine should be undertaken in a specialist unit in a hospital setting. Conventional therapy should be continued during ‘on’ phases.⁶

Continuous subcutaneous apomorphine infusions should be evaluated before more invasive measures or neurosurgical interventions are contemplated. ⁷

MOVAPO continuous infusion as second line treatment, has clinically proven benefits and is an effective option for patients with Parkinson’s Disease who are experiencing severe fluctuations and are poorly controlled by conventional oral therapy. ^3,7,8

• MOVAPO significantly reduced ‘off’ time by 40-85% vs baseline (p = 0.0003)³*
• MOVAPO significantly reduced dyskinesias during ‘on’ time and reduced the severity of dyskinesias that do occur by 15- 65% vs baseline (p = 0.0003) ^{3,7^*}
• MOVAPO allowed reductions of 15-80% in levodopa doses vs baseline (p = 0.003), reducing the treatment burden for patients³*
• MOVAPO on average, decreased ‘off’ time by approximately 5.5 hours per waking day vs baseline (p < 0.0001)^8¥

*Bhidayasiri et al is a review article that provides an overview of the pharmacokinetic properties and efficacy of apomorphine given intermittently and as continuous infusion for patients with Parkinson’s Disease and otherwise intractable motor fluctuations as an alternative to other dopaminergic treatment.³

^Deleu et al is a comprehensive systematic review of literature from 1960 to 2004 via MEDLINE and EMBASE of subcutaneous apomorphine across its different indications in Parkinson’s disease.⁷

¥Ruiz et al is a retrospective study that evaluated 82 patients with Parkinson’s Disease (disease duration 14.39 years ±5.7, mean age 67 years ±11.07) and severe motor fluctuations treated long-term with continuous subcutaneous apomorphine infusion over a mean follow-up period of 19.93 months ±16.3. The mean daily dose of apomorphine was 72 mg.⁸

A recent innovation to the MOVAPO range is the MOVAPO^® pre-filled syringe (PFS). It simplifies the administration of this medication for patients, nurses and carers.⁶ Doctors can confidently transition patients from MOVAPO ampoules to MOVAPO PFS.⁶

• MOVAPO PFS provides accurate dosing – there is no requirement for mixing or diluting apomorphine
• MOVAPO PFS minimises risks of injury – no ampoule breakages, no sharp needles for mixing
• MOVAPO PFS reduces monthly consumables costs – no requirement for saline for dilutions
• MOVAPO PFS is easy to administer – there is a simple connection between PFS and Mark II or Mark III pump

• Public Hospital Prescriptions: For those prescribers initiating MOVAPO pre-filled syringes (PFS) in a public hospital a streamlined code 10950H will need to be included on all prescriptions
• Private Hospital Prescriptions: Those specialists initiating MOVAPO pre-filled syringes (PFS) in a private practice or private hospital setting using an S100 Highly Specialised Drug Authority Prescription (PBS/RPBS), will need to provide Medicare Australia with the prescribing code 10971K, and the private hospital provider number.

STADA, established itself in Australia and New Zealand in 2016 with its full focus and commitment on Parkinson’s Disease, those physicians and nurses treating the disease, the patients and their carers. STADA aims to improve the lives and outcomes of patients living with disease through a variety of recently launched initiatives including:

• A new variable flow rate infusion Mark III pump
• A new format of MOVAPO in a pre-filled syringe improving administration
• The STADA Nurse Advisor service who train prescribers, patients and carers how to administer MOVAPO PFS with the Mark II or Mark III pumps
• iMOVE programme, (available from the APP Store or Google Play, computer or phone), provides patients with:
  • The ability to order consumables via the iMOVE shop
  • Access to a full suite of patient support materials, including instructions and troubleshooting guides, videos, brochures, travel letters, and more
  • Instant contact with the STADA Nurse Advisor Service
  • A simple referral tool to share with friends and carers
• The STADA Wall is available via myINTERACT, and is a platform that allows healthcare professionals easy access to relevant and engaging content on smartphones or tablets and can be downloaded via the APP store or Google play. This resource provides HCPs with immediate access to the STADA Nurse Service, educational resources that can be used with patients, regulatory and reimbursement information and events and activities.

If you need additional information on MOVAPO, STADA support programmes or Parkinson’s Disease, please make contact with the most appropriate person listed below.

Helen Tye, STADA Sales and Marketing Manager. E: Helen.Tye@stada.com.au, P: 0448 583 050

Sharon Benedierks, STADA Nurse Advisor Team leader, E; Sharon.Benedierks@stada.com.au, P: 0439 685 438 

STADA Medical Information Team: E: medinfo@stada.com.au, P: 1800 791 660

iMOVE Consumables Shop: https://www.imoveshop.com, P: 1800 339 953

References:

1. Deloitte Access Economics Report “Living with Parkinson’s Disease An updated economic analysis 2014 Parkinson’s Australia Inc”. August 2015
2. Pedrosa DJ, Timmermann L Neuropsychiatric Disease and Treatment 2013:9 321–340
3. Bhidayasiri R et al. Clin Neuropharm 2015;38:80-103
4. Merrinan S et al. Mov Disord 2014:29(1):23-32
5. Pfeiffer R et al. Parkinsonism Relat Disord 2011;17:10-15
6. MOVAPO PFS Australian Product Information
7. Deleu D et al. Drugs Aging 2004;21(11); 687-709
8. Ruiz PJG et al. Mov Disord 2008;23(8):1130–1136