Supernus' Onapgo: A Game Changer in Parkinson's Disease Treatment

Supernus Pharmaceuticals, Inc. (SUPN) has received a significant boost with the FDA approval of its Onapgo device, a novel treatment for motor fluctuations in adults with advanced Parkinson's disease (PD). The device, a wearable subcutaneous infusion of apomorphine, offers a non-invasive alternative to existing treatments, bypassing gastrointestinal issues and providing more predictable symptom control.

The approval of Onapgo is based on data from the Phase 3 TOLEDO study, which demonstrated a statistically significant reduction in mean daily OFF time compared with placebo. The intervention group, with a mean final drug dose of 4.68 mg/hour, showed significant improvements, including a reduction in OFF time of –2.47 hours/day compared with –0.58 hours/day for placebo (P =.0025), and an increase in ON time without troublesome dyskinesia of 2.77 hours/day versus 0.80 hours/day for placebo (P =.0008). Additionally, 62% of the apomorphine group were responders compared with 29% in the placebo group (P =.0008).



The timeline for Onapgo dates back to September 2020, when Supernus sent its original new drug application (NDA) to the FDA. The regulatory process was marked by delays and challenges, including a refusal to file letter and subsequent complete response letters (CRLs) from the FDA. However, the eventual approval of Onapgo demonstrates Supernus' commitment to persevering through challenges and ultimately bringing a beneficial product to patients.

The approval of Onapgo is expected to have a significant impact on the broader Parkinson's disease treatment landscape. As the first and only subcutaneous apomorphine infusion device approved by the FDA for the treatment of motor fluctuations in adults with advanced Parkinson's disease, Onapgo offers a non-invasive alternative to existing treatments, bypassing gastrointestinal issues and providing more predictable symptom control. The device's continuous subcutaneous infusion of apomorphine allows for more consistent control of OFF time, which can improve the quality of life for patients with Parkinson's disease.

The success of Onapgo may encourage other biopharmaceutical companies to invest in the development of similar devices or alternative therapies that target motor fluctuations in Parkinson's disease. Moreover, the comprehensive support program that Supernus Pharmaceuticals plans to offer alongside Onapgo, including a robust nurse education program and access support at launch, can help ensure that patients and healthcare providers are well-informed about the device's benefits and proper usage. This support program can also facilitate the adoption of Onapgo and other innovative therapies in the future, as it addresses potential barriers to access and utilization.

In conclusion, the FDA approval of Supernus' Onapgo device represents a significant milestone in the treatment of Parkinson's disease. The device's advantages, including its non-invasive nature, bypassing gastrointestinal issues, and providing more predictable symptom control, position it as a strong contender in the market. The approval also signals a shift in the treatment landscape for Parkinson's disease, as it demonstrates the potential for innovative, non-invasive therapies to address unmet needs in the patient population. As Supernus Pharmaceuticals continues to develop and commercialize products for the treatment of central nervous system (CNS) diseases, the success of Onapgo may pave the way for future innovations in the field.