Valldeoriola F, Cobaleda S, Lahuerta J
Movement Disorders Unit, Department of Neurology, Institut de Neurociències, Hospital Clínic, Barcelona, Spain.
Clin Neurol Neurosurg. 2009 Nov;111(9):742-7. doi: 10.1016/j.clineuro.2009.07.018. Epub 2009 Sep 3.
To evaluate the use of the non-ergot dopamine agonist ropinirole (RPN) in patients with Parkinson's disease in Spain, and to examine its effectiveness and tolerability in both monotherapy and combination therapy.
Fifty-two investigators participated in this study. Patients receiving RPN under usual clinical care conditions in Spanish Neurology outpatient clinic settings were identified (n=643) out of these, a random sample of 423 clinical records of patients treated with RPN in the previous 18 months was selected. The endpoints analyzed were: percentage of patients remaining on treatment during the period of study (maintenance), reported adverse reactions and treatment withdrawal (tolerability), changes in symptoms' severity as assessed by the Clinical Global Impression-Improvement (CGI-I) scale (effectiveness), and start-to-end mean RPN dose.
Patients were 68.6+/-9.7 years old (mean+/-SD) and 57.6% were male. RPN was administered as monotherapy (24%) or add-on treatment (76%). The mean maintenance dose was 9.54+/-5.34mg/day. Adverse reactions were reported by 28.6% patients, the most frequent being somnolence and sedation (9.2%), gastrointestinal symptoms (6.9%), increase in dyskinesia (5.9%), and orthostatic symptoms (3.8%). Treatment was withdrawn in 14.4% of patients, because of adverse reactions (5.9%), lack of efficacy (2.1%), change in treatment or clinical trial inclusion (1.9%) or other reasons (4.5%). Neurologists considered that improvement was achieved in 81.5% of patients, according to CGI-I scale.
The low incidence of adverse reactions and low rate of treatment withdrawal observed in this study support the effectiveness and tolerability of RPN in the treatment of Parkinson's disease.
评估非麦角多巴胺激动剂罗匹尼罗(RPN)在西班牙帕金森病患者中的使用情况,并研究其在单药治疗和联合治疗中的有效性和耐受性。
52名研究人员参与了本研究。在西班牙神经病学门诊常规临床护理条件下接受RPN治疗的患者被识别出来(n = 643),从中随机抽取了423例在过去18个月接受RPN治疗的患者的临床记录样本。分析的终点指标包括:研究期间继续接受治疗的患者百分比(维持率)、报告的不良反应和治疗中断情况(耐受性)、通过临床总体印象改善量表(CGI-I)评估的症状严重程度变化(有效性)以及RPN从开始到结束的平均剂量。
患者年龄为68.6±9.7岁(均值±标准差),男性占57.6%。RPN作为单药治疗(24%)或联合治疗(76%)给药。平均维持剂量为9.54±5.34mg/天。28.6%的患者报告了不良反应,最常见的是嗜睡和镇静(9.2%)、胃肠道症状(6.9%)、运动障碍增加(5.9%)和体位性症状(3.8%)。14.4%的患者因不良反应(5.9%)缺乏疗效(2.1%)、治疗改变或临床试验纳入(1.9%)或其他原因(4.5%)而中断治疗。根据CGI-I量表,神经科医生认为81.5%的患者病情有所改善。
本研究中观察到的不良反应发生率低和治疗中断率低,支持了RPN在帕金森病治疗中的有效性和耐受性。