Abstract

Objective

To provide the epidemiology of skin events occurring during long-term administration of medications delivered by continuous subcutaneous infusion pump (CSIP) systems as background rates for the development of novel CSIP treatments to use in community-based settings.

Methods

Using a United Kingdom general practice database, we conducted a study to assess the rates of skin events among new users of apomorphine and insulin delivered by CSIP in patients with Parkinson’s disease or diabetes, respectively. Skin events included skin infections, skin nodules/localized swelling, dermatitis/eczema, urticaria/erythema, and rash/other non-specific skin eruptions.

Results

Five hundred and fifty-seven adults (age 30+) were included in this descriptive cohort. The median duration of CSIP use was 17 months among 255 apomorphine users and 41 months among 302 insulin users. By 60 months, ∼40% of both cohorts experienced skin events. Repeated skin events occurred in 11% of the apomorphine cohort and 14% of the insulin cohort at any time during follow-up. The overall skin event rate in the apomorphine cohort was 17 per 1000 person-months (PM) and 13 per 1000 PM in the insulin cohort. The most common skin events in both cohorts were infection and rash/unspecified skin eruptions. The highest rates of skin events occurred soon after apomorphine CSIP initiation (36 per 1000 PM in weeks 1–2 and 50 per 1000 PM in weeks 3–4), with lower rates after 4 weeks. Insulin CSIP users’ skin event rates were consistent over the treatment duration.

Conclusions

Clinically important skin events are common during long-term administration of medications by CSIP.

中文翻译：

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慢性病皮下给药泵使用者皮肤事件发生率的流行病学

摘要

客观的

提供由连续皮下输液泵 (CSIP) 系统长期给药期间发生的皮肤事件的流行病学，作为开发用于社区环境的新型 CSIP 治疗的背景率。

方法

使用英国全科实践数据库，我们进行了一项研究，以分别评估 CSIP 提供的阿扑吗啡和胰岛素新用户在帕金森病或糖尿病患者中的皮肤事件发生率。皮肤事件包括皮肤感染、皮肤结节/局部肿胀、皮炎/湿疹、荨麻疹/红斑和皮疹/其他非特异性皮疹。

结果

该描述性队列中包括 557 名成年人（30 岁以上）。在 255 名阿扑吗啡使用者中，CSIP 使用的中位持续时间为 17 个月，在 302 名胰岛素使用者中为 41 个月。到 60 个月时，约 40% 的两个队列都经历了皮肤事件。在随访期间的任何时间，11% 的阿扑吗啡队列和 14% 的胰岛素队列都发生了重复的皮肤事件。阿扑吗啡队列中的总体皮肤事件发生率为每 1000 人月 (PM) 17 例，胰岛素队列中为每 1000 人月 13 例。两个队列中最常见的皮肤事件是感染和皮疹/未指明的皮疹。皮肤事件发生率最高的发生在阿扑吗啡 CSIP 开始后不久（第 1-2 周每 1000 PM 36 例，第 3-4 周每 1000 PM 50 例），4 周后发生率较低。

结论

临床上重要的皮肤事件在 CSIP 长期给药期间很常见。