Continuous under-skin apomorphine for people with advanced Parkinson's at the end of life
Interest of Continuous Subcutaneous Apomorphine in Parkinsonian Patients at the End of Life
Centre Hospitalier Régional d'Orléans · NCT07257861
This project will try continuous under‑skin apomorphine pumps to prevent dopaminergic withdrawal and ease symptoms for people with advanced Parkinson's who can no longer take oral medications near the end of life.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 80 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Centre Hospitalier Régional d'Orléans (other) |
| Locations | 1 site (Crest) |
| Trial ID | NCT07257861 on ClinicalTrials.gov |
What this trial studies
This observational study will follow adults with advanced Parkinson's who have an indication for an apomorphine pump and have lost oral intake, collecting questionnaire data from patients or trusted proxies. Patients receiving home palliative care who are started on continuous subcutaneous apomorphine will be described and outcomes such as dopaminergic withdrawal syndrome, symptom control, comfort, and place of death will be recorded. The protocol excludes those already using an apomorphine pump, people who oppose pump introduction, and legally protected or otherwise ineligible persons. Collected data will be used to characterize real‑world use of apomorphine pumps in end‑of‑life Parkinson's care and to inform best practices for symptom management.
Who should consider this trial
Good fit: Ideal participants are adults with advanced Parkinson's disease (Hoehn & Yahr OFF = 5) who have an indication for an apomorphine pump, have lost oral intake, are under palliative home care, and can consent or have a trusted proxy.
Not a fit: People already using an apomorphine pump, those who refuse pump treatment, or those who can still take oral antiparkinsonian medications are unlikely to benefit from this intervention.
Why it matters
Potential benefit: If successful, this approach could reduce severe dopaminergic withdrawal, improve comfort in the final days, and help more patients remain at home for end‑of‑life care.
How similar studies have performed: Retrospective work from Rennes and case series suggest continuous apomorphine can prevent withdrawal syndromes and improve comfort, but prospective or randomized evidence in end‑of‑life Parkinson's patients is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: 1. Person (or trusted person/relative if patient is unable) who has agreed to participate in the study 2. Patient of legal age 3. Advanced Parkinson's disease with apomorphine pump indication 4. Use of HH for palliative reasons 5. Loss of orality (discontinuation of oral treatments) 6. Hoehn \&Yahr score in OFF = 5 (bilateral and axial symptoms in the absence of levodopa) Exclusion Criteria: 1. Apomorphine pump already in use 2. Opposition to the introduction of an apomorphine pump 3. Protected person (under guardianship or curatorship) 4. Person under court protection 5. Persons deprived of liberty 6. Persons not affiliated to a social security scheme 7. Pregnant or breast-feeding woman
Where this trial is running
Crest
- Had Crest — Crest, France (RECRUITING)
Study contacts
- Study coordinator: Marc VERIN, MD PhD
- Email: marc.verin@chu-orleans.fr
- Phone: 02 38 51 48 86
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Parkinson Disease, Apomorphine, Parkinson, End of life