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Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease
- Source :
- Journal of Neurology
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- 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 P P 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.
- Subjects :
- medicine.medical_specialty
Levodopa
Complications
Parkinson's disease
Neurology
Apomorphine
Injections, Subcutaneous
Nodules
Parkinson’s disease
Safety
Skin
Antiparkinson Agents
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Prospective Studies
Prospective cohort study
Original Communication
business.industry
Apomorphin
Klinisk medicin
Public Health, Global Health, Social Medicine and Epidemiology
Parkinson Disease
Nodule (medicine)
medicine.disease
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
LOCAL TOLERANCE
Anesthesia
Neurology (clinical)
Clinical Medicine
Nodule formation
medicine.symptom
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 14321459 and 03405354
- Volume :
- 267
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology
- Accession number :
- edsair.doi.dedup.....65161f19da04976dd391c4a2838e7a9d