Buchwald B, Angersbach D, Jost W H
GlaxoSmithKline GmbH & Co KG, München.
Fortschr Neurol Psychiatr. 2007 Apr;75(4):236-41. doi: 10.1055/s-2007-959188.
Ropinirole is a non-ergoline selective D2 dopamine agonist. Its efficacy and safety has been established in several controlled double-blind studies in patients with early and advanced Parkinson's disease. It is assumed that the improvement in the activities of daily living under ropinirole is not only due to the improved motor symptoms but also due to the improvement of non-motor symptoms like symptoms of mood and anxiety. The objective of this post marketing surveillance study was to show that under the conditions of the daily routine in the neurologic practice ropinirole may not only improve motor symptoms, the activity of daily living and complications of the treatment (dystonia, dyskinesia) but also alleviate symptoms of depression and anxiety. A total of 110 neurological practices enrolled 327 patients in early and advanced stages of the disease (139 females, 188-males; mean age: 67 years). They were treated with ropinirole as monotherapy and as adjunctive therapy with l-dopa over a period of 12 - 14 weeks. Selected symptoms of the Unified Parkinson's Disease Rating Scale (UPDRS) part II-IV and symptoms of depression and anxiety were rated by the clinicians. Mood and functional impairment in job, family and social life were rated by the patients using selected items of the Beck Depression Inventory and the Sheehan Disability Scale (SDS). The different subtypes, i. e. the akinetic-rigid, tremor-dominant and the mixed subtype, are described separately. The total UPDRS score at baseline was similar for all three subtypes and there was also a similar improvement in the three groups under ropinirole. Both according to self-rating and to clinician rating the symptoms of depression and anxiety at baseline were more severe in the akinetic-rigid and the mixed subtype compared to the tremor-dominant subtype. The symptoms considerably improved and were reduced by 48 % under therapy with ropinirole. Adverse events were reported by 7.7 % of the patients. The surveillance study has shown that ropinirole may improve not only motor symptoms, activities of daily living and complications of treatment but also symptoms of mood and anxiety.
罗匹尼罗是一种非麦角林类选择性D2多巴胺激动剂。在多项针对早期和晚期帕金森病患者的对照双盲研究中,已证实了其疗效和安全性。据推测,服用罗匹尼罗后日常生活活动能力的改善不仅归因于运动症状的改善,还归因于非运动症状(如情绪和焦虑症状)的改善。这项上市后监测研究的目的是表明,在神经科日常诊疗的条件下,罗匹尼罗不仅可以改善运动症状、日常生活活动能力和治疗并发症(肌张力障碍、运动障碍),还可以缓解抑郁和焦虑症状。共有110家神经科诊所招募了327例处于疾病早期和晚期的患者(139例女性,188例男性;平均年龄:67岁)。他们接受罗匹尼罗单药治疗以及与左旋多巴联合治疗,为期12 - 14周。临床医生对统一帕金森病评定量表(UPDRS)第二至四部分的选定症状以及抑郁和焦虑症状进行评分。患者使用贝克抑郁量表和希恩残疾量表(SDS)的选定项目对工作、家庭和社会生活中的情绪和功能损害进行评分。分别描述了不同的亚型,即运动不能 - 强直型、震颤为主型和混合型。所有三种亚型在基线时的UPDRS总分相似,在罗匹尼罗治疗下三组也有相似的改善。根据自评和临床医生评分,与震颤为主型相比,运动不能 - 强直型和混合型在基线时的抑郁和焦虑症状更严重。在罗匹尼罗治疗下,症状有显著改善,减轻了48%。7.7%的患者报告了不良事件。该监测研究表明,罗匹尼罗不仅可以改善运动症状、日常生活活动能力和治疗并发症,还可以改善情绪和焦虑症状。