Evidence map›Paper›PMID 40627305›Full record

ArticleNeurology and therapy2025

Licensed Subcutaneous Infusion Therapies in Advanced Parkinson's Disease: An Indirect Treatment Comparison and Cost-Minimisation Analysis.

Marc Vérin, Ángel Sesar, Bharat Amlani, Niall Smith, Konstantinos Kipentzoglou, Stephen Montgomery, Alice Reading, Andrei Karlsson, Anna Willis, Andrew J Lees

2 registry-linked trialsAbstract read
In one paragraph

Article in Neurology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02006121 phase3completednot on this map

Multicentre,Parallel-group,Double-blind,Placebo-controlled Phase III Study to Evaluate the Efficacy and Safety of Apomorphine sc Infusion in Parkinson's Disease Patients With Motor Complications Not Well Controlled on Medical Treatment

TypeinterventionalSponsorBritannia Pharmaceuticals Ltd.Ran2014 to 2017Enrolled107ConditionsParkinson's DiseaseArmsApomorphine hydrochloride, Placebo
NCT04380142 phase3completednot on this map

A Randomized, Double-Blind, Double-Dummy, Active-Controlled Study Comparing the Efficacy, Safety and Tolerability of ABBV-951 to Oral Carbidopa/Levodopa in Advanced Parkinson's Disease Patients

TypeinterventionalSponsorAbbVieRan2020 to 2021Enrolled174ConditionsParkinson's Disease (PD)ArmsABBV-951, Placebo for Levodopa/Carbidopa (LD/CD), Levodopa/Carbidopa (LD/CD), Placebo for ABBV-951
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Refractory Motor Complications: Towards a Pragmatic Definition.Movement disorders clinical practice · 2026
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Marc VérinLaboratoire Interdisciplinaire Pour L'Innovation et La Recherche en Santé d'Orléans, Department of Neurology, University Hospital of Orléans, Orléans, France.ORCID http://orcid.org/0000-0002-2373-7836
Ángel SesarUnidad de Trastornos del Movimiento, Servicio de Neurología, Hospital Clínico Universitario, Santiago de Compostela, Spain.ORCID http://orcid.org/0000-0003-0511-0922
Bharat AmlaniBritannia Pharmaceuticals Ltd, Reading, UK.ORCID http://orcid.org/0000-0002-7384-7857
Niall SmithBritannia Pharmaceuticals Ltd, Reading, UK.ORCID http://orcid.org/0009-0000-1419-4094
Konstantinos KipentzoglouBritannia Pharmaceuticals Ltd, Reading, UK.
Stephen MontgomeryCostello Medical Consulting Ltd, Cambridge, UK.ORCID http://orcid.org/0000-0002-8481-5850
Alice ReadingCostello Medical Consulting Ltd, Cambridge, UK.
Andrei KarlssonCostello Medical Consulting Ltd, London, UK.
Anna WillisCostello Medical Consulting Ltd, London, UK.
Andrew J LeesNational Hospital, Queen Square and Reta Lila Weston Institute for Neurological Studies, University College London, London, UK. andrew.lees@ucl.ac.uk.ORCID http://orcid.org/0000-0002-2476-4385

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionParkinson's disease is the second most common neurodegenerative disorder. In advanced Parkinson's disease, subcutaneous (SC) infusion therapies represent minimally invasive and reversible treatment options. In the United Kingdom (UK), licensed SC infusion therapies include apomorphine and foslevodopa-foscarbidopa; both represent effective and generally well-tolerated therapies, although uncertainties regarding their relative efficacy, safety and costs remain.

methodsThe relative efficacy and safety of apomorphine and foslevodopa-foscarbidopa was assessed via Bucher indirect treatment comparison (ITC) of TOLEDO (NCT02006121) and M15-736 (NCT04380142) data, with findings used to support a cost-minimisation analysis (CMM). Thirteen outcomes were evaluated. Efficacy and safety outcomes were measured as mean differences and risk differences, respectively. The CMM, conducted from a UK healthcare payer perspective, considered treatment acquisition and concomitant therapy costs over a 6.34-year horizon (obtained from a published observational study).

resultsBucher ITC results provided evidence for a comparable efficacy for apomorphine and foslevodopa-foscarbidopa in advanced Parkinson's disease. ITCs also indicated comparable safety, although a trend in favour of apomorphine was identified for hallucinations and most infusion site reactions assessed. The CMM demonstrated a clear per-patient cost benefit for apomorphine versus foslevodopa-foscarbidopa (£120,173.70), primarily driven by lower drug acquisition costs.

conclusionThe main difference between UK licensed SC infusion therapies for advanced Parkinson's disease relates to cost as opposed to clinical outcome, with some evidence for improved tolerability of apomorphine. This supports the continued use of apomorphine as first-line SC infusion treatment for advanced Parkinson's disease in UK clinical practice.

Indexed as

ApomorphineContinuous dopaminergic stimulationDevice-aided therapyFoslevodopa–foscarbidopaParkinson's diseaseSubcutaneous infusions

Identifiers

PMID40627305
PMCPMC12450198

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.