Department of Neurology, University of Technology Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
Parkinsons Dis. 2011;2011:354760. doi: 10.4061/2011/354760. Epub 2011 May 11.
Patients undergoing long-term therapy for PD often experience motor fluctuations and nocturnal disturbances. In a post-hoc analysis, we explored effects of ropinirole prolonged release on sleep, night-time awakenings, and "on" time over 24 hours. Patients with advanced PD suboptimally controlled with L-dopa were randomized to adjunctive ropinirole prolonged release (2-24 mg/day) or placebo for 24 weeks. Awake/asleep and, if awake, "on"/"off" status was recorded via diary cards. At week 24 last observation carried forward, changes in nighttime or daytime sleep duration were not significantly different between treatments. Of patients with baseline awakenings, a significantly higher proportion in the ropinirole prolonged release group had a reduction in awakenings versus placebo. Patients receiving ropinirole prolonged release had a significantly greater increase in amount/percentage of awake time "on"/"on" without troublesome dyskinesia during all periods assessed (including night-time and early morning), versus placebo, and higher odds for being "on" on waking. Adjunctive once-daily ropinirole prolonged release may help provide 24-hour symptom control in patients with advanced PD not optimally controlled with L-dopa.
接受 PD 长期治疗的患者常出现运动波动和夜间紊乱。在一项事后分析中，我们探讨了罗匹尼罗控释片对睡眠、夜间觉醒和 24 小时内“开”时间的影响。接受左旋多巴治疗但控制不佳的晚期 PD 患者随机分为添加罗匹尼罗控释片（2-24mg/天）或安慰剂治疗 24 周。通过日记卡记录清醒/睡眠状态和如果清醒则“开”/“关”状态。在 24 周时最后一次观察到的结果推移分析中，两种治疗之间夜间或白天睡眠时间的变化无显著差异。基线时有觉醒的患者中，与安慰剂相比，罗匹尼罗控释片组有更多患者觉醒减少。与安慰剂相比，接受罗匹尼罗控释片治疗的患者在所有评估时段（包括夜间和清晨）的清醒时间“开”/“开”比例和时长均显著增加，且无明显运动障碍，醒来时的“开”的可能性更高。每日一次添加罗匹尼罗控释片可能有助于为接受左旋多巴治疗但控制不佳的晚期 PD 患者提供 24 小时症状控制。
