Benes Heike
Somni bene Institute for Medical Research and Sleep Medicine Schwerin Ltd, Arsenalstrasse 10, 19053 Schwerin, Germany.
Sleep Med. 2006 Jan;7(1):31-5. doi: 10.1016/j.sleep.2005.05.007. Epub 2005 Sep 27.
Restless legs syndrome (RLS) patients suffer from symptoms not only at bedtime but also with variable circadian patterns. Transdermal application forms of dopamine agonists are expected to lead to a stable plasma concentration of the active drug which could ease treatment for RLS patients with daytime symptoms and avoid side effects of oral dopaminergic therapies.
In this controlled pilot study, 10 patients (six females, four males, mean age 58 years) with severe and long-lasting idiopathic RLS were treated during an initial open-label phase for 2 weeks either with one (n=3 patients) or, if required, two patches of lisuride every other day (dose per patch: 3mg lisuride, nominal effective release rate 7.0 microg lisuride/h). Patients were then randomized to double-blind treatment with lisuride (n=5) or placebo (n=4) for 1 week.
Severity of RLS clearly improved during open-label and double-blind treatment with lisuride but became worse under placebo according to the International Restless Legs Syndrome Study Group Rating Scale (IRLS), RLS-6, and Clinical Global Impressions (CGIs) scales, and actigraphy assessments (periodic leg movement index) in the 1-week double-blind period.
The explorative findings of this small controlled study suggest that lisuride patches might be an efficacious treatment for RLS patients without clinically relevant tolerability problems.
不安腿综合征(RLS)患者不仅在就寝时出现症状,而且症状呈现出昼夜节律的变化。多巴胺激动剂的透皮贴剂有望使活性药物的血浆浓度保持稳定,从而缓解白天有症状的RLS患者的病情,并避免口服多巴胺能疗法的副作用。
在这项对照性初步研究中,10例(6例女性,4例男性,平均年龄58岁)患有严重且长期特发性RLS的患者,在初始开放标签阶段接受为期2周的治疗,其中3例患者每天使用1片(必要时2片)利舒脲贴剂(每片贴剂剂量:3mg利舒脲,标称有效释放率7.0μg利舒脲/小时)。随后,患者被随机分为两组,分别接受为期1周的利舒脲(n = 5)或安慰剂(n = 4)双盲治疗。
根据国际不安腿综合征研究组评分量表(IRLS)、RLS-6量表、临床总体印象(CGI)量表以及1周双盲期的活动记录仪评估(周期性腿部运动指数),在开放标签阶段和使用利舒脲双盲治疗期间,RLS的严重程度明显改善,但在使用安慰剂时病情恶化。
这项小型对照研究的探索性结果表明,利舒脲贴剂可能是治疗RLS患者的有效方法,且不存在临床相关的耐受性问题。