Lieberman A, Olanow C W, Sethi K, Swanson P, Waters C H, Fahn S, Hurtig H, Yahr M
Barrow Neurological Institute, Phoenix, AZ 85013-4496, USA.
Neurology. 1998 Oct;51(4):1057-62. doi: 10.1212/wnl.51.4.1057.
To evaluate the nonergot dopamine agonist ropinirole as an adjunct to L-dopa in a randomized, double-blind trial in PD patients with motor fluctuations.
L-dopa in the treatment of PD is associated with motor fluctuations, dyskinesia, and other adverse effects. The use of dopamine agonists in the treatment of PD delays recourse to L-dopa and thus delays the possibility of adverse effect onset.
Ropinirole (n = 95) or placebo (n = 54) was added to L-dopa, and L-dopa was then reduced in a planned manner during the 6-month trial.
A significantly greater number of ropinirole patients were able to achieve a 20% or greater reduction in both L-dopa dose and in percent time spent "off" compared with placebo (35.0% versus 13.0%; p = 0.003). The mean daily L-dopa dose was reduced significantly with ropinirole treatment (242 mg versus 51 mg; p < 0.001) as was the percent awake time spent "off" (11.7% versus 5.1%; p = 0.039). There was no difference in the percent of patients who withdrew because of adverse effects (15.8% on ropinirole versus 16.7% on placebo).
Ropinirole permits a reduction in L-dopa dose with enhanced clinical benefit for PD patients with motor fluctuations.
在一项针对有运动波动的帕金森病患者的随机双盲试验中，评估非麦角多巴胺激动剂罗匹尼罗作为左旋多巴辅助药物的效果。
左旋多巴用于治疗帕金森病会引发运动波动、异动症及其他不良反应。使用多巴胺激动剂治疗帕金森病可延迟使用左旋多巴，从而延缓不良反应的发生。
在左旋多巴治疗基础上加用罗匹尼罗（n = 95）或安慰剂（n = 54），然后在为期6个月的试验中按计划减少左旋多巴用量。
与安慰剂组相比，罗匹尼罗组有更多患者能够使左旋多巴剂量及“关”期时间百分比降低20%或更多（35.0%对13.0%；p = 0.003）。罗匹尼罗治疗使平均每日左旋多巴剂量显著降低（242毫克对51毫克；p < 0.001），“关”期清醒时间百分比也显著降低（11.7%对5.1%；p = 0.039）。因不良反应退出的患者百分比无差异（罗匹尼罗组为15.8%，安慰剂组为16.7%）。
对于有运动波动的帕金森病患者，罗匹尼罗可降低左旋多巴剂量并增强临床疗效。
