| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Barrow Neurological Institute (Dr. Lieberman), Phoenix, AZ; the Mount Sinai School of Medicine (Drs. Olanow and Yahr), New York, NY; the Medical College of Georgia (Dr. Sethi), Augusta, GA; the University of Washington School of Medicine (Dr. Swanson), Seattle, WA; the University of Southern California (Dr. Waters), Los Angeles, CA; the Neurological Institute of New York (Dr. Fahn), Columbia University, New York, NY; and the Graduate Hospital (Dr. Hurtig), Philadelphia, PA.
Address correspondence and reprint requests to Dr. Abraham Lieberman, Barrow Neurological Institute, 222 W. Thomas Road, Suite 401, Phoenix, AZ 85013-4496.
Objective: To evaluate the nonergot dopamine agonist ropinirole as an adjunct to L-dopa in a randomized, double-blind trial in PD patients with motor fluctuations.
Background: L-dopa in the treatment of PD is associated with motor fluctuations, dyskinesia, and other adverse effects. The use of dopamine agonists in the treatment of PD delays recourse to L-dopa and thus delays the possibility of adverse effect onset.
Methods: Ropinirole (n = 95) or placebo (n = 54) was added to L-dopa, and L-dopa was then reduced in a planned manner during the 6-month trial.
Results: A significantly greater number of ropinirole patients were able to achieve a 20% or greater reduction in both L-dopa dose and in percent time spent "off" compared with placebo (35.0% versus 13.0%; p = 0.003). The mean daily L-dopa dose was reduced significantly with ropinirole treatment (242 mg versus 51 mg; p < 0.001) was the percent awake time spent "off" (11.7% versus 5.1%; p = 0.039). There was no difference in the percent of patients who withdraw because of adverse effects (15.8% on ropinirole versus 16.7% on placebo).
Conclusions: Ropinirole permits a reduction in L-dopa dose with enhanced clinical benefit for PD patients with motor fluctuations.
*See the Appendix on page 1061 for a list of investigators and institutions of the Ropinirole Study Group.
Supported by SmithKline Beechman (SB) Pharmaceuticals.
Presented in part at the 48th annual meeting of the American Academy of Neurology; San Francisco, CA; March 1996.
This article has been cited by other articles:
|
|
 |
|
  C. W. Olanow, M. B. Stern, and K. Sethi The scientific and clinical basis for the treatment of Parkinson disease (2009) Neurology, May 26, 2009; 72(21_Supplement_4): S1 - S136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. H. Waters and J. J. Chen Pharmacologic Options for Treatment of Levodopa-Associated ``Wearing Off'' Journal of Pharmacy Practice, August 1, 2008; 21(4): 254 - 261. [Abstract] [PDF]
|
|
|
|
|
|
P. A. LeWitt, K. E. Lyons, R. Pahwa, and on behalf of the SP 650 Study Group Advanced Parkinson disease treated with rotigotine transdermal system: PREFER Study Neurology, April 17, 2007; 68(16): 1262 - 1267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pahwa, M. A. Stacy, S. A. Factor, K. E. Lyons, F. Stocchi, B. P. Hersh, L. W. Elmer, D. D. Truong, N. L. Earl, and on behalf of the EASE-PD Adjunct Study Investigato Ropinirole 24-hour prolonged release: Randomized, controlled study in advanced Parkinson disease Neurology, April 3, 2007; 68(14): 1108 - 1115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Watts, J. Jankovic, C. Waters, A. Rajput, B. Boroojerdi, and J. Rao Randomized, blind, controlled trial of transdermal rotigotine in early Parkinson disease Neurology, January 23, 2007; 68(4): 272 - 276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pahwa, S. A. Factor, K. E. Lyons, W. G. Ondo, G. Gronseth, H. Bronte-Stewart, M. Hallett, J. Miyasaki, J. Stevens, and W. J. Weiner Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, April 11, 2006; 66(7): 983 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Parkinson Study Group A Randomized Placebo-Controlled Trial of Rasagiline in Levodopa-Treated Patients With Parkinson Disease and Motor Fluctuations: The PRESTO Study Arch Neurol, February 1, 2005; 62(2): 241 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Horn and M. B. Stern The comparative effects of medical therapies for Parkinson's disease Neurology, October 12, 2004; 63(7_suppl_2): S7 - S12. [Full Text]
|
|
|
|
|
|
R. B. Dewey Jr. Management of motor complications in Parkinson's disease Neurology, March 23, 2004; 62(6_suppl_4): S3 - S7. [Abstract] [Full Text]
|
|
|
|
|
|
A.H. V. Schapira Disease-modifying strategies and challenges in PD: Interactive breakout sessions Neurology, September 23, 2003; 61(90063): S56 - 63. [Full Text]
|
|
|
|
|
|
J. C. Chappell and H. Cohen Frontiers in Neuropharmacotherapy Part II: Multiple Sclerosis and Parkinson's Disease Journal of Pharmacy Practice, June 1, 2002; 15(3): 221 - 240. [Abstract] [PDF]
|
|
|
|
|
|
R. G. Holloway and A. W. Dick Clinical trial end points: On the road to nowhere? Neurology, March 12, 2002; 58(5): 679 - 686. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Olanow The role of dopamine agonists in the treatment of early Parkinson's disease Neurology, February 1, 2002; 58(90001): S33 - 41. [Abstract] [Full Text]
|
|
|
|
|
|
J. P. Hubble Long-term studies of dopamine agonists Neurology, February 1, 2002; 58(90001): S42 - 50. [Abstract] [Full Text]
|
|
|
|
|
|
C. W. Olanow, R. L. Watts, and W. C. Koller An algorithm (decision tree) for the management of Parkinson's disease (2001):: Treatment Neurology, June 12, 2001; 56(suppl_5): S1 - S88. [Full Text] [PDF]
|
|
|
|
 |
|
 A Münchau and K P Bhatia Pharmacological treatment of Parkinson's disease Postgrad. Med. J., October 1, 2000; 76(900): 602 - 610. [Full Text]
|
|
|
|
 |
|
 D J BROOKS Dopamine agonists: their role in the treatment of Parkinson's disease J. Neurol. Neurosurg. Psychiatry, June 1, 2000; 68(6): 685 - 689. [Full Text] [PDF]
|
|
|
|
 |
|
 O. Rascol, D. J. Brooks, A. D. Korczyn, P. P. De Deyn, C. E. Clarke, A. E. Lang, and The 056 Study Group A Five-Year Study of the Incidence of Dyskinesia in Patients with Early Parkinson's Disease Who Were Treated with Ropinirole or Levodopa N. Engl. J. Med., May 18, 2000; 342(20): 1484 - 1491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Jeret and A. N. Lieberman A multicenter trial of ropinirole as adjunct treatment for PD Neurology, August 1, 1999; 53(3): 656 - 656. [Full Text]
|
|
|
|
|
|
R. Pahwa, S. A. Factor, K. E. Lyons, W. G. Ondo, G. Gronseth, H. Bronte-Stewart, M. Hallett, J. Miyasaki, J. Stevens, and W. J. Weiner Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, April 11, 2006; 66(7): 983 - 995. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
