Personality and Quality of Life Amelioration After Continuous Subcutaneous Apomorphine Infusion in Parkinson's Disease

NCT ID: NCT06080399

Last Updated: 2024-08-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-02-15

Study Completion Date

2026-04-01

Brief Summary

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Since our previous study has shown that some personality dimensions were associated with Quality of Life (QoL) amelioration after Deep Brain Stimulation (DBS) in Parkinson's disease (PD), the investigators aim to evaluate the impact of personality dimensions on therapeutic response after another second-line treatment: the continuous subcutaneous apomorphine infusion (CSAI). Moreover, the investigators would like to evaluate the potential evolution of personality dimensions through CSAI. The investigators also aim to evaluate other bio-psycho-social factors (representations of the disease, ways of copying and social support) influence on QoL amelioration after DBS.

Detailed Description

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As Parkinson's disease (PD) progresses, the onset of motor and non-motor fluctuations alters patients Quality of Life (QoL). Second-line treatments can then be proposed: either the implantation of deep brain electrodes (Deep Brain Stimulation of the Sub-Thalamic Nuclei (DBS-STN)), or the drug approach (continuous subcutaneous infusion of apomorphine or continuous intrajejunal infusion of levodopa/carbidopa).

To date, no randomized double-blind trial has compared the efficacy and adverse effects of these different types of second-line treatments. There is therefore no clearly defined predictive factor that could predict better efficacy of these second-line treatments in patients, or the occurrence of adverse effects leading to discontinuation of these treatments.

The choice of treatment must consider patients specific personal needs as well as their clinical phenotype, this constitutes the major challenge of personalized medicine. Thus, personality, which reflects the way a person thinks, reflects, acts and behaves in different situations, appears to be a possible predictive criterion for QoL improvement after second-line treatments.

Indeed, using the Temperament and Character Inventory (TCI) self-questionnaire, the investigators have shown that two personality dimensions of the TCI ("Novelty Seeking" and "Cooperativeness") appeared to be predictive of QoL amelioration in PD patients after DBS-STN. Thus, the use of this personality questionnaire, the TCI, enables better prediction of patients therapeutic response after DBS-STN. It could also be useful to predict therapeutic response after other second-line treatments such as continuous subcutaneous infusion of apomorphine. In this study, the investigators therefore propose to evaluate the impact of personality dimensions on therapeutic response after the introduction of this infusion therapy.

Investigators carried out a preliminary exploratory study (PSYCHO-PERF study - ClinicalTrials.gov NCT03793491) which showed a significant association between a personality dimension of the TCI ("Reward Dependence") and QoL improvement after six months of continuous subcutaneous infusion of apomorphine in 33 PD patients (article in preparation). This suggests that patients with high Reward Dependence scores may be good candidates for continuous subcutaneous infusion of apomorphine. However, these results need to be confirmed on a larger scale, by means of a multicenter study.

Hence, some TCI personality dimensions in PD patients could be predictive of QoL improvement after second-line treatment. Thus, before proposing a second-line treatment, in the context of personalized medicine, personality assessment could be one of the criteria to choose between these different treatments.

However, the investigators are aware that PD patients personality can only partly explain the therapeutic response. For this reason, the investigators also wish to include in our study other psycho-bio-social factors (social representations of the disease and treatments, coping strategies and social support perceived by patients) that may influence QoL improvement following treatment.

In a more exploratory context, the investigators would also like to assess changes in TCI personality dimensions of PD patients following treatment with continuous subcutaneous infusion of apomorphine, since changes in mood and/or behavior have already been observed. If a change is observed, the investigators will determine whether this change is associated with clinical and demographic data prior to the continuous infusion.

Conditions

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Parkinson Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Continuous subcutaneous apomorphine infusion (CSAI)

the CSAI proposed in the usual healthcare pathway of each PD patients included

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Parkinson's disease patients as defined by the United Kingdom Parkinson's disease Brain Bank (UKPDSBB) criteria and aged from 40 to 75 years old (included)
* Patients with motor fluctuations and/or invalidating dyskinesia and awaiting CSAI establishment in the context of their usual care for PD
* Patients affiliated to a social security system

Exclusion Criteria

* Patients presenting an atypical parkinsonian syndrome Patients having a Deep Brain Stimulation
* Patients with a psychiatric disease such as bipolar disorder or delusions linked to a dopaminergic psychosis
* Patients presenting a cognitive deficit attested by a score to the Montreal Cognitive Assessment inferior to 24, solely during the inclusion (baseline - V0)
* Patient with a serious pathology (e.g. cancer) or a health condition which could interfere with the assessment of their quality of life, at the discretion of the investigator upon inclusion
* Patients under guardianship, curatorship or safeguard of justice
* Patients under exclusion period from another study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ELIVIE France

UNKNOWN

Sponsor Role collaborator

EVER Pharma France SAS

UNKNOWN

Sponsor Role collaborator

NHC SAS, France

UNKNOWN

Sponsor Role collaborator

Orkyn'

INDUSTRY

Sponsor Role collaborator

ETPARK Association, Toulouse, France

UNKNOWN

Sponsor Role collaborator

University Hospital, Toulouse

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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CHRISTINE BREFEL COURBON

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Toulouse

Locations

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Chu de Lyon

Bron, , France

Site Status RECRUITING

Hopital Gabriel Montpied

Clermont-Ferrand, , France

Site Status RECRUITING

Chu de Grenoble

Grenoble, , France

Site Status RECRUITING

Chu Limoges

Limoges, , France

Site Status RECRUITING

Chu de Nancy

Nancy, , France

Site Status RECRUITING

Chu de Nice

Nice, , France

Site Status RECRUITING

Chu de Poitiers

Poitiers, , France

Site Status RECRUITING

Chu de Rennes

Rennes, , France

Site Status RECRUITING

Chu de Rouen

Rouen, , France

Site Status RECRUITING

Chu de Toulouse

Toulouse, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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CHRISTINE BREFEL COURBON

Role: CONTACT

(0)5 61 77 25 35 ext. +33

ESTELLE HARROCH

Role: CONTACT

Facility Contacts

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STEPHANE THOBOIS

Role: primary

ANA MARQUES

Role: primary

ELENA MORO

Role: primary

JEAN-LUC HOUETO

Role: primary

SOLENE FRISMAND

Role: primary

CAROLINE GIORDANA

Role: primary

ISABELLE BENATRU

Role: primary

SOPHIE DRAPIER

Role: primary

DAVID MALTETE

Role: primary

CHRISTINE BREFEL COURBON

Role: primary

References

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Boussac M, Harroch E, Barthelemy C, Ory-Magne F, Leung C, Fabbri M, Arbus C, Brefel-Courbon C. Personality and quality-of-life improvement after apomorphine infusion in Parkinson's disease. Brain Commun. 2024 May 24;6(3):fcae181. doi: 10.1093/braincomms/fcae181. eCollection 2024.

Reference Type RESULT
PMID: 38846534 (View on PubMed)

Other Identifiers

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RC31/23/0401

Identifier Type: -

Identifier Source: org_study_id

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