Mochizuki Hideki, Hattori Nobutaka, Hasegawa Kazuko, Nomoto Masahiro, Uchida Eiji, Terahara Takaaki, Okawa Koji, Fukuta Hiroyuki
Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Neurology, Juntendo University Faculty of Medicine, Tokyo, Japan.
Parkinsonism Relat Disord. 2021 Feb;83:105-109. doi: 10.1016/j.parkreldis.2020.12.023. Epub 2021 Jan 11.
A dopamine agonist patch could be an important treatment option for Parkinson's disease. This study evaluated the long-term efficacy and safety of the ropinirole hydrochloride patch. The steady state plasma ropinirole concentration was also assessed.
In a multicenter, open-label, uncontrolled study, Parkinson's disease patients with/without basal levodopa and with/without prior dopamine agonist therapy (any of these four regimens) received application of a ropinirole patch once daily for up to 52 weeks with unforced titration from 8 to 64 mg. For patients with prior dopamine agonist therapy, the initial dose of ropinirole patch was determined from the prior dopamine agonist dose by using a conversion table.
Most adverse events were mild or moderate. All application site adverse events were mild, except for moderate application site erythema in one patient. In patients with prior dopamine agonist therapy, switching to ropinirole patch did not lead to a significant early increase of adverse events. A change from baseline in the UPDRS Part III total score, the primary efficacy endpoint, showed improvement until Week 16 compared with baseline, followed by little subsequent change until Week 52, indicating maintenance of efficacy. The plasma ropinirole concentration was at steady state throughout the study period and showed a dose-proportional increase.
Once-daily application of ropinirole patch showed long-term efficacy and safety (52 weeks) for Parkinson's disease. Switching from other dopamine agonists to ropinirole patch was effective and safe. The plasma ropinirole concentration was at steady state throughout the study period and showed a dose-proportional increase.
多巴胺激动剂贴片可能是帕金森病的一种重要治疗选择。本研究评估了盐酸罗匹尼罗贴片的长期疗效和安全性。还评估了罗匹尼罗的稳态血浆浓度。
在一项多中心、开放标签、非对照研究中,接受或未接受左旋多巴基础治疗、接受或未接受过多巴胺激动剂治疗(这四种治疗方案中的任何一种)的帕金森病患者,每天使用一次罗匹尼罗贴片,持续长达52周,从8毫克至64毫克进行非强制性滴定。对于曾接受过多巴胺激动剂治疗的患者,根据先前多巴胺激动剂的剂量,使用换算表确定罗匹尼罗贴片的初始剂量。
大多数不良事件为轻度或中度。除一名患者出现中度贴片部位红斑外,所有贴片部位不良事件均为轻度。在曾接受多巴胺激动剂治疗的患者中,改用罗匹尼罗贴片并未导致不良事件在早期显著增加。作为主要疗效终点的UPDRS第三部分总分与基线相比,在第16周时显示改善,随后直到第52周变化不大,表明疗效得以维持。在整个研究期间,罗匹尼罗的血浆浓度处于稳态,并呈剂量比例增加。
每日一次应用罗匹尼罗贴片对帕金森病显示出长期疗效和安全性(52周)。从其他多巴胺激动剂改用罗匹尼罗贴片是有效且安全的。在整个研究期间,罗匹尼罗的血浆浓度处于稳态,并呈剂量比例增加。