General Internal Medicine Clinic, Montefiore Hospital, 9 South, 200 Lothrop Street, Pittsburgh, PA, 15217, USA.
George E Wahlen VAMC, 500 Foothill Dr, Salt Lake City, UT, 84103, USA.
Dig Dis Sci. 2018 Mar;63(3):687-693. doi: 10.1007/s10620-018-4937-3. Epub 2018 Jan 30.
Nausea and vomiting are commonly associated with medication use. Dopaminergic agonists have been associated with these symptoms, but their impact in patients without Parkinson's disease, such as those with restless legs syndrome (RLS), is not well characterized.
We sought to determine whether the non-ergoline dopamine agonist ropinirole is associated with nausea and vomiting in adults with RLS.
We conducted a systematic review using PUBMED, EMBASE, and clinical trial databases to identify placebo-controlled clinical trials of ropinirole for RLS treatment. We extracted data including dosing schedule and the proportion of patients reporting nausea and/or vomiting. We also determined hazard ratios (HR) using a random effects proportional hazard model.
We extracted data from a pool of 13 studies. The prevalence of nausea in the ropinirole-treated RLS group (RLS-R; N = 1528) was 37.2% compared to 9.4% in the placebo-treated RLS group (RLS-P; N = 1395) (p < 0.0001). The prevalence of vomiting in the RLS-R group was 10.9% compared to 2.6% in the RLS-P group (p < 0.0001). Ropinirole use was associated with a higher risk of reporting nausea (HR 5.924 [4.410-7.959], p < 0.001) and experiencing vomiting (HR 4.628 [3.035-7.057], p < 0.0001). Nausea and vomiting represented nearly 50% of all adverse events reported.
Nausea and vomiting are quite common side effects in those using ropinirole for RLS. As RLS is more widely recognized and treated; the prevalence of ropinirole-induced nausea and vomiting could grow substantially. Ropinirole use should be considered as a cause of chronic nausea and vomiting.
恶心和呕吐通常与药物使用有关。多巴胺激动剂与这些症状有关，但在没有帕金森病的患者中，例如不安腿综合征（RLS）患者，其影响尚不清楚。
我们旨在确定非麦角类多巴胺激动剂罗匹尼罗是否与 RLS 成人患者的恶心和呕吐有关。
我们使用 PUBMED、EMBASE 和临床试验数据库进行了系统评价，以确定用于 RLS 治疗的罗匹尼罗的安慰剂对照临床试验。我们提取的数据包括剂量方案和报告恶心和/或呕吐的患者比例。我们还使用随机效应比例风险模型确定了风险比（HR）。
我们从 13 项研究中提取了数据。罗匹尼罗治疗的 RLS 组（RLS-R；N=1528）恶心的患病率为 37.2%，而安慰剂治疗的 RLS 组（RLS-P；N=1395）为 9.4%（p<0.0001）。RLS-R 组呕吐的患病率为 10.9%，而 RLS-P 组为 2.6%（p<0.0001）。罗匹尼罗的使用与报告恶心的风险增加相关（HR 5.924 [4.410-7.959]，p<0.001）和经历呕吐（HR 4.628 [3.035-7.057]，p<0.0001）。恶心和呕吐占报告的所有不良事件的近 50%。
在使用罗匹尼罗治疗 RLS 的患者中，恶心和呕吐是相当常见的副作用。随着 RLS 得到更广泛的认识和治疗；罗匹尼罗引起的恶心和呕吐的患病率可能会大幅增加。应将罗匹尼罗的使用视为慢性恶心和呕吐的原因。
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