Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Sleep Med. 2010 Jan;11(1):11-6. doi: 10.1016/j.sleep.2009.03.009. Epub 2009 Dec 4.
To evaluate the efficacy of pramipexole on polysomnographic measures, patient ratings and a clinical rating in Japanese patients with primary restless legs syndrome (RLS).
Patients with moderate to severe RLS having periodic limb movements in bed index (PLMI)>or=5 were randomly assigned to receive pramipexole or placebo in a 6-week, double-blind, placebo-controlled study with forced titration from 0.125 to 0.75mg/day. Both polysomnography (PSG) and the suggested immobilization test (SIT) were performed at baseline and 6weeks after starting treatment.
The analysis of covariance of log-transformed PLMI showed that the adjusted means at the end of study were significantly smaller in the pramipexole group than in the placebo group (p=0.0019). In all patients, variables on SIT did not show any differences between the two groups, whereas a significant improvement was shown in the pramipexole group compared with the placebo group for patients with a SIT-PLM index at baseline >or=15. Pramipexole group showed a significant reduction in the International Restless Legs Syndrome Study Group rating scale (IRLS; p=0.0005), a significant improvement in both Patient Global Impression (PGI; p<0.0001) and Clinical Global Impressions (CGI-I; p=0.0488), and a significantly greater mean reduction in the Pittsburgh Sleep Quality Index (PSQI; p=0.0016), when compared with those of placebo group at week 6.
Pramipexole is highly efficacious in the reduction of PLMI and in the improvement of subjective severity of RLS and subjective sleep disturbance caused by the disorder.
评估普拉克索治疗日本原发性不安腿综合征(RLS)患者的多导睡眠图(PSG)测量指标、患者评分和临床评分的疗效。
中重度 RLS 患者的周期性肢体运动指数(PLMI)>或=5,被随机分配接受普拉克索或安慰剂治疗,为期 6 周,双盲,安慰剂对照,强制滴定剂量为 0.125 至 0.75mg/天。在开始治疗前和 6 周后均进行 PSG 和建议的固定试验(SIT)。
经对数转换的 PLMI 的协方差分析显示,研究结束时的调整平均值在普拉克索组明显小于安慰剂组(p=0.0019)。在所有患者中,SIT 的变量在两组之间没有差异,而在 SIT-PLM 指数基线>或=15 的患者中,普拉克索组与安慰剂组相比,显著改善。与安慰剂组相比,普拉克索组的国际不安腿综合征研究组评分量表(IRLS;p=0.0005)显著降低,患者总体印象(PGI;p<0.0001)和临床总体印象(CGI-I;p=0.0488)均显著改善,匹兹堡睡眠质量指数(PSQI;p=0.0016)的平均降低也显著更大,与安慰剂组相比,第 6 周时。
普拉克索在降低 PLMI 以及改善 RLS 的主观严重程度和由该疾病引起的主观睡眠障碍方面非常有效。