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Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson's disease

Hagell, Peter (author)
Patient Reported Outcomes - Clinical Assessment Research and Education (PROCARE),Department of Nursing and Integrated Health Sciences,Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap,The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, 291 88, Kristianstad, Sweden
Höglund, Arja (author)
Karolinska Institutet,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden,Karolinska University Hospital,Karolinska Universitetssjukhuset
Hellqvist, Carina, 1976- (author)
Linköpings universitet,Avdelningen för omvårdnad och reproduktiv hälsa,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping,Linköping University Hospital,Universitetssjukhuset i Linköping
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Johansson, Eva-Lena (author)
Karlstad Central Hospital,Centralsjukhuset Karlstad,Department of Neurology, Karlstad Central Hospital, Karlstad, Sweden
Löwed, Berit (author)
Karlstad Central Hospital,Centralsjukhuset Karlstad,Department of Neurology, Karlstad Central Hospital, Karlstad, Sweden
Sjöström, Anne-Christine (author)
Sahlgrenska University Hospital,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Karlberg, Carina (author)
Sahlgrenska University Hospital,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Lundgren, Margareth (author)
Karolinska University Hospital,Karolinska Universitetssjukhuset,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
Dizdar, Nil, 1960- (author)
Linköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping,Linköping University
Johansson, Anders (author)
Karolinska Institutet,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden,Karolinska University Hospital,Karolinska Universitetssjukhuset
Willows, Thomas (author)
Karolinska University Hospital,Karolinska Universitetssjukhuset,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
Rådberg, Johan (author)
Karlstad Central Hospital,Centralsjukhuset Karlstad,Department of Neurology, Karlstad Central Hospital, Karlstad, Sweden
Bergquist, Filip (author)
Sahlgrenska University Hospital,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
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 (creator_code:org_t)
2020-07-01
2020
English 6
In: Journal of Neurology. - : D. Steinkopff-Verlag. - 0340-5354 .- 1432-1459. ; 267:11, s. 3411-3417
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson's disease (PD), but a limitation is the formation of troublesome s.c. nodules. Various chemically non-identical apomorphine formulations are available. Anecdotal experiences have suggested that shifting from one of these (Apo-Go PumpFill®; apoGPF) to another (Apomorphine PharmSwed®; apoPS) may influence the occurrence and severity of s.c. nodules. We, therefore, followed 15 people with advanced PD (median PD-duration, 15 years; median "off"-phase Hoehn and Yahr, IV) on apoGPF and with troublesome s.c. nodules who were switched to apoPS. Data were collected at baseline, at the time of switching, and at a median of 1, 2.5, and 7.3 months post-switch. Total nodule numbers (P < 0.001), size (P < 0.001), consistency (P < 0.001), skin changes (P = 0.058), and pain (P ≤ 0.032) improved over the observation period. PD severity and dyskinesias tended to improve and increase, respectively. Apomorphine doses were stable, but levodopa doses increased by 100 mg/day. Patient-reported apomorphine efficacy tended to increase and all participants remained on apoPS throughout the observation period; with the main patient-reported reason being improved nodules. These observations suggest that patients with s.c. nodules caused by apoGPF may benefit from switching to apoPS in terms of s.c. nodule occurrence and severity. Alternatively, observed benefits may have been due to the switch itself. As nodule formation is a limiting factor in apomorphine treatment, a controlled prospective study comparing local tolerance with different formulations is warranted.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

Apomorphine; Complications; Nodules; Parkinson’s disease; Safety; Skin

Publication and Content Type

ref (subject category)
art (subject category)

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