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Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease
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 on...
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| Published in: | Journal of neurology 2020, Vol.267 (11), p.3411-3417 |
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| container_end_page | 3417 |
| container_issue | 11 |
| container_start_page | 3411 |
| container_title | Journal of neurology |
| container_volume | 267 |
| creator | Hagell, Peter Höglund, Arja Hellqvist, Carina Johansson, Eva-Lena Löwed, Berit Sjöström, Anne-Christine Karlberg, Carina Lundgren, Margareth Dizdar, Nil Johansson, Anders Willows, Thomas Rådberg, Johan Bergquist, Filip |
| description | 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
|
| doi_str_mv | 10.1007/s00415-020-10031-1 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_470054</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2471644384</sourcerecordid><originalsourceid>FETCH-LOGICAL-c710t-6b9508161f77f126621dc13f53cef3f33c63d21e50dec6c1213bf15cfa049f43</originalsourceid><addsrcrecordid>eNqFk81u1DAQxyMEoqXwApwiceFAwOPP5IJUlU-pEhwqrpbj2LvuJnawk6LeuPMEvB5PgtNdWhap5RTH85v_zN-aKYqngF4CQuJVQogCqxBGVf4nUMG94hAowRVQ1twvDhGhqGKE0YPiUUrnCKE6Bx4WBwRzIJSyw-LH8RiGEMe186a0IQ5zryYXfDmoy9J528_Ga1OmudXzpLwJcyp1GMbe6SsulTaGIV_5yfl5ie6h6i_1rDanRdr58rOKG-dT8L--_0xl55JRyTwuHljVJ_Nk9z0qzt69PTv5UJ1-ev_x5Pi00gLQVPG2YagGDlYIC5hzDJ0GYhnRxhJLiOakw2AY6ozmGjCQ1gLTViHaWEqOimorm76ZcW7lGN2g4qUMysnd1SafjKQCIbbwq1v5aHLnUa_HECfVy_UmLomqG5yXmb1-Jal5hxEjXOLadJKiVsjaYioRMh1vNFWkbXOl5tZKYwzdTXt_WgRKUc2wIHe6euO-HMsQV7J3swSRJ2Rx9eL__OIH5wJNxl9v8cwOptPGTzEb3utwL-LdWq7ChRRM1EB5Fni-E4jh62zSJAeXtOn77aRITKERgJEQGX32D3oe5ujzSGRKAKeU1IsBvKV0DClFY6-bASSX_ZDb_ZB5P-TVfkjISWTnOsN-ZeKN9B1ZvwHP8RtL</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2471644384</pqid></control><display><type>article</type><title>Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease</title><source>Springer Nature</source><creator>Hagell, Peter ; Höglund, Arja ; Hellqvist, Carina ; Johansson, Eva-Lena ; Löwed, Berit ; Sjöström, Anne-Christine ; Karlberg, Carina ; Lundgren, Margareth ; Dizdar, Nil ; Johansson, Anders ; Willows, Thomas ; Rådberg, Johan ; Bergquist, Filip</creator><creatorcontrib>Hagell, Peter ; Höglund, Arja ; Hellqvist, Carina ; Johansson, Eva-Lena ; Löwed, Berit ; Sjöström, Anne-Christine ; Karlberg, Carina ; Lundgren, Margareth ; Dizdar, Nil ; Johansson, Anders ; Willows, Thomas ; Rådberg, Johan ; Bergquist, Filip ; Patient Reported Outcomes - Clinical Assessment Research and Education (PROCARE) ; Faculty of Health Science ; Högskolan Kristianstad ; Kristianstad University ; Fakulteten för hälsovetenskap ; Department of Nursing and Integrated Health Sciences ; Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap</creatorcontrib><description>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.</description><identifier>ISSN: 0340-5354</identifier><identifier>ISSN: 1432-1459</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-020-10031-1</identifier><identifier>PMID: 32613445</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Apomorphine ; Clinical Medicine ; Klinisk medicin ; Levodopa ; Medical and Health Sciences ; Medicin och hälsovetenskap ; Medicine ; Medicine & Public Health ; Movement disorders ; Neurodegenerative diseases ; Neurology ; Neuroradiology ; Neurosciences ; Nodules ; Original Communication ; Pain ; Parkinson's disease ; Ultrasonic imaging</subject><ispartof>Journal of neurology, 2020, Vol.267 (11), p.3411-3417</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c710t-6b9508161f77f126621dc13f53cef3f33c63d21e50dec6c1213bf15cfa049f43</citedby><cites>FETCH-LOGICAL-c710t-6b9508161f77f126621dc13f53cef3f33c63d21e50dec6c1213bf15cfa049f43</cites><orcidid>0000-0003-2174-372X ; 0000-0003-4626-6552 ; 0000-0001-9212-8877 ; 0000-0002-3928-5184 ; 0000-0002-3437-0267 ; 0000-0002-9556-6984</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttp://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-20859$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-174324$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:144085273$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uoai:researchportal.hkr.se/admin:publications/c6d20536-28ed-40b7-8f24-00ed69c4a3bb$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Hagell, Peter</creatorcontrib><creatorcontrib>Höglund, Arja</creatorcontrib><creatorcontrib>Hellqvist, Carina</creatorcontrib><creatorcontrib>Johansson, Eva-Lena</creatorcontrib><creatorcontrib>Löwed, Berit</creatorcontrib><creatorcontrib>Sjöström, Anne-Christine</creatorcontrib><creatorcontrib>Karlberg, Carina</creatorcontrib><creatorcontrib>Lundgren, Margareth</creatorcontrib><creatorcontrib>Dizdar, Nil</creatorcontrib><creatorcontrib>Johansson, Anders</creatorcontrib><creatorcontrib>Willows, Thomas</creatorcontrib><creatorcontrib>Rådberg, Johan</creatorcontrib><creatorcontrib>Bergquist, Filip</creatorcontrib><creatorcontrib>Patient Reported Outcomes - Clinical Assessment Research and Education (PROCARE)</creatorcontrib><creatorcontrib>Faculty of Health Science</creatorcontrib><creatorcontrib>Högskolan Kristianstad</creatorcontrib><creatorcontrib>Kristianstad University</creatorcontrib><creatorcontrib>Fakulteten för hälsovetenskap</creatorcontrib><creatorcontrib>Department of Nursing and Integrated Health Sciences</creatorcontrib><creatorcontrib>Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap</creatorcontrib><title>Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><description>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.</description><subject>Apomorphine</subject><subject>Clinical Medicine</subject><subject>Klinisk medicin</subject><subject>Levodopa</subject><subject>Medical and Health Sciences</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Nodules</subject><subject>Original Communication</subject><subject>Pain</subject><subject>Parkinson's disease</subject><subject>Ultrasonic imaging</subject><issn>0340-5354</issn><issn>1432-1459</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFk81u1DAQxyMEoqXwApwiceFAwOPP5IJUlU-pEhwqrpbj2LvuJnawk6LeuPMEvB5PgtNdWhap5RTH85v_zN-aKYqngF4CQuJVQogCqxBGVf4nUMG94hAowRVQ1twvDhGhqGKE0YPiUUrnCKE6Bx4WBwRzIJSyw-LH8RiGEMe186a0IQ5zryYXfDmoy9J528_Ga1OmudXzpLwJcyp1GMbe6SsulTaGIV_5yfl5ie6h6i_1rDanRdr58rOKG-dT8L--_0xl55JRyTwuHljVJ_Nk9z0qzt69PTv5UJ1-ev_x5Pi00gLQVPG2YagGDlYIC5hzDJ0GYhnRxhJLiOakw2AY6ozmGjCQ1gLTViHaWEqOimorm76ZcW7lGN2g4qUMysnd1SafjKQCIbbwq1v5aHLnUa_HECfVy_UmLomqG5yXmb1-Jal5hxEjXOLadJKiVsjaYioRMh1vNFWkbXOl5tZKYwzdTXt_WgRKUc2wIHe6euO-HMsQV7J3swSRJ2Rx9eL__OIH5wJNxl9v8cwOptPGTzEb3utwL-LdWq7ChRRM1EB5Fni-E4jh62zSJAeXtOn77aRITKERgJEQGX32D3oe5ujzSGRKAKeU1IsBvKV0DClFY6-bASSX_ZDb_ZB5P-TVfkjISWTnOsN-ZeKN9B1ZvwHP8RtL</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Hagell, Peter</creator><creator>Höglund, Arja</creator><creator>Hellqvist, Carina</creator><creator>Johansson, Eva-Lena</creator><creator>Löwed, Berit</creator><creator>Sjöström, Anne-Christine</creator><creator>Karlberg, Carina</creator><creator>Lundgren, Margareth</creator><creator>Dizdar, Nil</creator><creator>Johansson, Anders</creator><creator>Willows, Thomas</creator><creator>Rådberg, Johan</creator><creator>Bergquist, Filip</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>ALKSL</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D96</scope><scope>ZZAVC</scope><scope>ABXSW</scope><scope>DG8</scope><orcidid>https://orcid.org/0000-0003-2174-372X</orcidid><orcidid>https://orcid.org/0000-0003-4626-6552</orcidid><orcidid>https://orcid.org/0000-0001-9212-8877</orcidid><orcidid>https://orcid.org/0000-0002-3928-5184</orcidid><orcidid>https://orcid.org/0000-0002-3437-0267</orcidid><orcidid>https://orcid.org/0000-0002-9556-6984</orcidid></search><sort><creationdate>2020</creationdate><title>Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease</title><author>Hagell, Peter ; Höglund, Arja ; Hellqvist, Carina ; Johansson, Eva-Lena ; Löwed, Berit ; Sjöström, Anne-Christine ; Karlberg, Carina ; Lundgren, Margareth ; Dizdar, Nil ; Johansson, Anders ; Willows, Thomas ; Rådberg, Johan ; Bergquist, Filip</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c710t-6b9508161f77f126621dc13f53cef3f33c63d21e50dec6c1213bf15cfa049f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Apomorphine</topic><topic>Clinical Medicine</topic><topic>Klinisk medicin</topic><topic>Levodopa</topic><topic>Medical and Health Sciences</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Movement disorders</topic><topic>Neurodegenerative diseases</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Nodules</topic><topic>Original Communication</topic><topic>Pain</topic><topic>Parkinson's disease</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hagell, Peter</creatorcontrib><creatorcontrib>Höglund, Arja</creatorcontrib><creatorcontrib>Hellqvist, Carina</creatorcontrib><creatorcontrib>Johansson, Eva-Lena</creatorcontrib><creatorcontrib>Löwed, Berit</creatorcontrib><creatorcontrib>Sjöström, Anne-Christine</creatorcontrib><creatorcontrib>Karlberg, Carina</creatorcontrib><creatorcontrib>Lundgren, Margareth</creatorcontrib><creatorcontrib>Dizdar, Nil</creatorcontrib><creatorcontrib>Johansson, Anders</creatorcontrib><creatorcontrib>Willows, Thomas</creatorcontrib><creatorcontrib>Rådberg, Johan</creatorcontrib><creatorcontrib>Bergquist, Filip</creatorcontrib><creatorcontrib>Patient Reported Outcomes - Clinical Assessment Research and Education (PROCARE)</creatorcontrib><creatorcontrib>Faculty of Health Science</creatorcontrib><creatorcontrib>Högskolan Kristianstad</creatorcontrib><creatorcontrib>Kristianstad University</creatorcontrib><creatorcontrib>Fakulteten för hälsovetenskap</creatorcontrib><creatorcontrib>Department of Nursing and Integrated Health Sciences</creatorcontrib><creatorcontrib>Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium 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(PROCARE)</aucorp><aucorp>Faculty of Health Science</aucorp><aucorp>Högskolan Kristianstad</aucorp><aucorp>Kristianstad University</aucorp><aucorp>Fakulteten för hälsovetenskap</aucorp><aucorp>Department of Nursing and Integrated Health Sciences</aucorp><aucorp>Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><date>2020</date><risdate>2020</risdate><volume>267</volume><issue>11</issue><spage>3411</spage><epage>3417</epage><pages>3411-3417</pages><issn>0340-5354</issn><issn>1432-1459</issn><eissn>1432-1459</eissn><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
< 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32613445</pmid><doi>10.1007/s00415-020-10031-1</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2174-372X</orcidid><orcidid>https://orcid.org/0000-0003-4626-6552</orcidid><orcidid>https://orcid.org/0000-0001-9212-8877</orcidid><orcidid>https://orcid.org/0000-0002-3928-5184</orcidid><orcidid>https://orcid.org/0000-0002-3437-0267</orcidid><orcidid>https://orcid.org/0000-0002-9556-6984</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0340-5354 |
| ispartof | Journal of neurology, 2020, Vol.267 (11), p.3411-3417 |
| issn | 0340-5354 1432-1459 1432-1459 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_470054 |
| source | Springer Nature |
| subjects | Apomorphine Clinical Medicine Klinisk medicin Levodopa Medical and Health Sciences Medicin och hälsovetenskap Medicine Medicine & Public Health Movement disorders Neurodegenerative diseases Neurology Neuroradiology Neurosciences Nodules Original Communication Pain Parkinson's disease Ultrasonic imaging |
| title | Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T04%3A01%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Apomorphine%20formulation%20may%20influence%20subcutaneous%20complications%20from%20continuous%20subcutaneous%20apomorphine%20infusion%20in%20Parkinson%E2%80%99s%20disease&rft.jtitle=Journal%20of%20neurology&rft.au=Hagell,%20Peter&rft.aucorp=Patient%20Reported%20Outcomes%20-%20Clinical%20Assessment%20Research%20and%20Education%20(PROCARE)&rft.date=2020&rft.volume=267&rft.issue=11&rft.spage=3411&rft.epage=3417&rft.pages=3411-3417&rft.issn=0340-5354&rft.eissn=1432-1459&rft_id=info:doi/10.1007/s00415-020-10031-1&rft_dat=%3Cproquest_swepu%3E2471644384%3C/proquest_swepu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c710t-6b9508161f77f126621dc13f53cef3f33c63d21e50dec6c1213bf15cfa049f43%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2471644384&rft_id=info:pmid/32613445&rfr_iscdi=true |