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.

皮下连续皮下注射阿扑吗啡是治疗帕金森氏病（PD）的有效疗法，但局限性是麻烦的皮结节的形成。可以使用多种化学上不同的阿扑吗啡制剂。轶事经验表明，从这些（APO-转到PumpFill之一移位^® ; apoGPF）到另一个（阿朴吗啡PharmSwed ^® ; apoPS）可能影响皮下结节的发生和严重程度。因此，我们追踪了15位使用apoGPF的晚期PD患者（PD的中位持续时间为15年； Hoehn和Yahr，IV的中位“休”期），并伴有麻烦的结节切换为apoPS。数据是在基线时，切换时以及切换后1、2.5和7.3个月的中值收集的。总结节数（P <0.001），大小（P  <0.001），稠度（P  <0.001），皮肤变化（P  = 0.058）和疼痛（P ≤0.032）在观察期内有所改善。PD严重度和运动障碍分别倾向于改善和增加。阿扑吗啡剂量稳定，但左旋多巴剂量增加100 mg / day。患者报告的阿扑吗啡功效倾向于增加，并且在整个观察期内所有参与者均保持在apoPS上。患者报告的主要原因是结节得到改善。这些观察结果表明，就结节的发生和严重程度而言，由apoGPF引起的结节结节患者可能受益于改用apoPS。可替代地，观察到的益处可能归因于开关本身。由于结节的形成是阿扑吗啡治疗的限制因素，因此有必要进行对照前瞻性研究，以比较不同制剂的局部耐受性。