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Uprima (apomorphine sublingual - apo SL)
Sequential administration enhances the effect of apomorphine SL in men with erectile dysfunction.
Heaton JP, Dean J, Sleep DJ.
Queens University, Kingston, Ontario, Canada. heatonj@post.queens.ca
The response to Uprima (apomorphine sublingual, (apo SL)) has been well documented in conventional clinical trials. Apo SL produces a predictable, consistent and durable response across a wide variety of patients. The positive reinforcement of a successful outcome should further support clinical benefit.
Apo SL with its rapid onset affords a greater opportunity for spontaneity, which can be an important factor in influencing patient choice. It is recognised that patient counselling and the setting of realistic expectations are vital to a successful outcome. The impact of persisting with sequential treatment on outcome has been calculated from the clinical data. While apo SL is effective de novo in 50% of single doses, additional benefit is observed with repeat dosing.
Full benefit may not be achieved until four or more treatments have been taken in an optimal setting. The data also confirm that 3 mg has superior activity. Patients should therefore be encouraged to try a minimum of 4 doses at 3 mg.
PMID: 11896482 [PubMed - indexed for MEDLINE]
Characterising the benefit of apomorphine SL ( Uprima) as an optimised treatment for representative populations with erectile dysfunction.
Heaton JP.
Queen's University, Kingston, Ontario, Canada. heatonj@post.queensu.ca
The clinical profile for apomorphine sublingual (SL) ( Uprima), a new centrally active agent for the management of the erectile dysfunction (ED) patient, is described in this article. Apomorphine SL is shown to be rapid in onset (71% of patients within 20 min) with a consistent, predictable response that is independent of severity (mild, moderate or severe), the underlying aetiology or the presence of significant co-morbidities (coronary artery disease, hypertension, etc). Importantly, there is also consistent long-term clinical benefit (>90% of attempts being successful over 18 months), for patients who respond to therapy and a benign side effect profile (<13.4% patients with adverse events). This formulation of apomorphine has a speed of onset and overall clinical profile that may offer particular advantages to the patient in terms of spontaneity and predictability of response. ED is a complex disease of varying aetiologies and severities often associated with a number of co-morbidities that require diverse solutions.
Given the need for customization of therapy to individual patient needs, the clinical profile of apomorphine SL would indicate that it will make a most welcome addition to the physician's armamentarium against ED.
Publication Types:
Review
Review, Tutorial
PMID: 11477490 [PubMed - indexed for MEDLINE]