title: Quality of life in Parkinson's disease improved by apomorphine pump: the OPTIPUMP cohort study.
abstract: To report on OPTIPUMP, a cohort study, investigating the impact in real-life clinical settings of continuous subcutaneous apomorphine infusion (CSAI) on the quality of life (HRQoL) of patients with Parkinson's disease. OPTIPUMP was a prospective, open-label, observational cohort study involving 30 investigational sites in France. CSAI was proposed as part of routine clinical care to patients aged ≥18 years, in absence of dementia, with a PD diagnosis and based on the presence of motor fluctuations not controlled by oral treatments. The impact of APO-pump on quality of life was evaluated as the difference in PDQ-39 scores between the initiation treatment and the follow-up visit after 6 months' treatment. All adverse events were recorded. Hyper- and hypodopaminergic behavioral tolerance was assessed on the Ardouin Scale of Behavior in Parkinson's Disease. Between September 2011 and January 2013, we enrolled 142 patients: 42 patients were withdrawn due to pump removal (33), death (4), lost of follow-up (4), no available data (1). 100 completed the study. At 6 months, their HRQoL had significantly improved (p = 0.011), as had their total UPDRS score (p < 0.001). Regarding the safety profile, Ardouin scale scores indicated that their hyperdopaminergic behaviors had not increased. CSAI had a favorable impact on HRQoL, with benefits outweighing risks. The analysis of the withdrawn patients highlights the heterogeneity of the use of the pump having an impact on its efficacy and tolerability.
authors.affiliation: Department of Neurology, EA 4712, University Rennes 1, CHU Pontchaillou, 2 Henri Le Guilloux, 35000, Rennes, France. sophie.drapier@chu-rennes.fr.|Neurology Department, University Hospital, 2 rue Henri Le Guilloux, 35200, Rennes, France. sophie.drapier@chu-rennes.fr.
authors.forename: Sophie
authors.initials: S
authors.lastname: Drapier
authors.affiliation: Department of Neurology and Movement Disorders, APHM Timone University Hospital and Institut de Neurosciences de la Timone, AMU-CNRS UMR 7289, Marseilles, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Eusebio
authors.affiliation: Department of Neurology, Centre Expert et Inter-Régional de Coordination de la Maladie de Parkinson, Hôpital de la Pitié-Salpêtrière, APHP, 47-83 boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Degos
authors.affiliation: Department of Neurology, EA 4712, University Rennes 1, CHU Pontchaillou, 2 Henri Le Guilloux, 35000, Rennes, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Vérin
authors.affiliation: Department of Movement Disorders and Neurology, CHU Clermont-Ferrand, 58 rue Montalembert, 63003, Clermont-Ferrand, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Durif
authors.affiliation: Department of Neurology and Movement Disorders, APHM Timone University Hospital and Institut de Neurosciences de la Timone, AMU-CNRS UMR 7289, Marseilles, France.
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Azulay
authors.affiliation: Department of Neurology, University Hospital, Avenue des Tamaris, 13616, Aix-En-Provence, France.
authors.forename: François
authors.initials: F
authors.lastname: Viallet
authors.affiliation: Department of Neurology, CHU Nantes, boulevard Jacques-Monod-Saint-Herblain, 44093, Nantes, France.
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Rouaud
authors.affiliation: Department of Movement Disorders and Neurology, INSERM U1171, Lille University, CHU Lille, 2, avenue Oscar Lambret, 59037, Lille, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
authors.affiliation: Department of Movement Disorders and Neurology, INSERM U1171, Lille University, CHU Lille, 2, avenue Oscar Lambret, 59037, Lille, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Defebvre
authors.affiliation: Department of Psychiatry and Neurology, CHU Grenoble, Avenue Maquis du Grésivaudan, 38700, La Tronche, France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Fraix
authors.affiliation: Department of Movement Disorders and Neurology, CHU Strasbourg, 1 Place de L Hôpital, 67000, Strasbourg, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Tranchant
authors.affiliation: CLINACT Groupe, Sèvre, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Andre
authors.affiliation: Department of Clinical Pharmacology and Neurosciences, UMR 825 Inserm, University Hospital Toulouse III, 31059, Toulouse, France.
authors.forename: Christine Brefel
authors.initials: CB
authors.lastname: Courbon
authors.affiliation: Department of Neurology, Assistance Publique Hôpitaux de Paris, Inserm, U 1127, CNRS, UMR 7225, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Sorbonne Universités, 47-83 boulevard de l'Hôpital, 75013, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Roze
authors.affiliation: Department of Medical Pharmacology, INSERM U1171, Lille University, CHU Lille, 2, avenue Oscar Lambret, 59037, Lille, France.
authors.forename: David
authors.initials: D
authors.lastname: Devos
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001058:Apomorphine / Q000008:administration & dosage* / Q000009:adverse effects; D018491:Dopamine Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects; D055104:Infusions, Subcutaneous / Q000009:adverse effects; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D001058:Apomorphine
keywords: Apomorphine pump; Parkinson’s disease; Quality of life