Abstract
BACKGROUND: Continuous subcutaneous foslevodopa/foscarbidopa (CSFLI) is emerging as a new treatment for advanced Parkinson's disease (APD), but its efficacy and safety as a second-line infusion therapy in patients previously treated with apomorphine remain to be clarified. OBJECTIVES: The aim of this study was to evaluate the short-term clinical impact of switching from continuous subcutaneous apomorphine infusion (CSAI) to CSFLI in a real-world cohort. METHODS: We conducted a retrospective observational study including 14 patients with APD who transitioned from CSAI to CSFLI. Clinical assessments were performed at baseline (M0) and 3 months after the switch (M3). RESULTS: At M3, motor complications (Movement Disorder Society-the Unified Parkinson's Disease Rating Scale [MDS-UPDRS Part IV]) were significantly reduced, with improvements in functional scores (Part II), quality of life (Parkinson's Disease Questionnaire-8 [PDQ-8]), clinical global impression of severity (CGI-S), and neuropsychiatric inventory (NPI). No patient discontinued treatment. Two patients developed de novo apathy. CONCLUSION: Switching from CSAI to CSFLI is feasible, effective, and well tolerated. Behavioral changes observed in two cases underline the need for clinical awareness when treating patients with subtle cognitive vulnerability.