Boston Collaborative Drug Surveillance Program, Lexington, MA, USA.
Boston University School of Public Health, Boston, MA, USA.
Curr Med Res Opin. 2021 Sep;37(9):1563-1571. doi: 10.1080/03007995.2021.1953971. Epub 2021 Jul 20.
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.
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.
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.
Clinically important skin events are common during long-term administration of medications by CSIP.
为新型 CSIP 治疗在社区环境中的应用提供长期使用皮下连续输注泵（CSIP）系统给药时发生皮肤事件的流行病学背景率。
我们利用英国普通实践数据库，研究了分别使用 CSIP 输送阿扑吗啡和胰岛素治疗帕金森病或糖尿病患者中新使用者的皮肤事件发生率。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/其他非特异性皮肤疹。
本描述性队列纳入了 557 名年龄在 30 岁以上的成年人。255 名阿扑吗啡使用者中 CSIP 使用的中位时间为 17 个月，302 名胰岛素使用者中 CSIP 使用的中位时间为 41 个月。到 60 个月时，两个队列中约有 40%的患者发生了皮肤事件。在任何随访期间，阿扑吗啡队列中有 11%和胰岛素队列中有 14%的患者出现反复皮肤事件。阿扑吗啡队列的总体皮肤事件发生率为每 1000 人月（PM）17 例，胰岛素队列为每 1000 PM 13 例。两个队列中最常见的皮肤事件均为感染和皮疹/未特指皮肤疹。阿扑吗啡 CSIP 启动后不久（第 1-2 周 36 例/1000 PM，第 3-4 周 50 例/1000 PM）皮肤事件发生率最高，4 周后发生率降低。胰岛素 CSIP 用户的皮肤事件发生率在整个治疗期间保持一致。
长期使用 CSIP 给药时，临床上重要的皮肤事件很常见。
