Ten-Year Follow-Up of Parkinson's Disease Patients Randomized to Initial Therapy with Ropinirole or Levodopa
Identifieur interne : 002882 ( Main/Merge ); précédent : 002881; suivant : 002883Ten-Year Follow-Up of Parkinson's Disease Patients Randomized to Initial Therapy with Ropinirole or Levodopa
Auteurs : Robert A. Hauser [États-Unis] ; Olivier Rascol [France] ; Amos D. Korczyn [Israël] ; A. Jon Stoessl [Canada] ; Ray L. Watts [États-Unis] ; Werner Poewe [Autriche] ; Peter P. De Deyn [Belgique] ; Anthony E. Lang [Canada]Source :
- Movement disorders [ 0885-3185 ] ; 2007.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
Abstract
In a 5-year, double-blind study, subjects with Parkinson's disease (PD) who were randomized to initial treatment with ropinirole had a significantly lower incidence of dyskinesia compared with subjects randomized to levodopa, although Unified Parkinson's Disease Rating Scale (UPDRS) motor scores were significantly more improved in the levodopa group. Subjects who completed the original study were eligible to participate in a long-term extension study conducted according to an open, naturalistic design and were evaluated approximately every 6 months until they had been followed for a total of 10 years. Comparing subjects randomized to initial treatment with ropinirole (n = 42) and levodopa (n = 27), the incidence of dyskinesia was significantly lower in the ropinirole group (adjusted odds ratio [OR] = 0.3; 95% confidence interval [CI]: 0.1, 1.0; P = 0.046) and the median time to dyskinesia was significantly longer (adjusted hazard ratio = 0.4; 95% CI: 0.2, 0.8; P = 0.007). The incidence of at least moderate wearing off ("off' time ≥ 26% of the awake day) was also significantly lower in the ropinirole group (adjusted OR = 0.3; 95% Cl. 0.09, 0.03; P = 0.03). There were no significant differences change in UPDRS activities of daily living or motor scores, o scores for the 39-item PD questionnaire, Clinical Global Im pression, or the Epworth Sleepiness Scale. Early treatment decisions for individual patients depend largely on the antici pated risk of side effects and long-term complications. Both ropinirole and levodopa are viable treatment options in eaily PD.
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Hauser</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>University of South Florida</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Korczyn, Amos D" sort="Korczyn, Amos D" uniqKey="Korczyn A" first="Amos D." last="Korczyn">Amos D. 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De Deyn</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>University of Antwerp</s1><s2>Antwerp</s2><s3>BEL</s3><sZ>7 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName><orgName type="university">Université d'Anvers</orgName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>8 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto Western Hospital</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0146745</idno><date when="2007">2007</date><idno type="stanalyst">PASCAL 08-0146745 INIST</idno><idno type="RBID">Pascal:08-0146745</idno><idno type="wicri:Area/PascalFrancis/Corpus">000664</idno><idno type="wicri:Area/PascalFrancis/Curation">000646</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000592</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000592</idno><idno type="wicri:doubleKey">0885-3185:2007:Hauser R:ten:year:follow</idno><idno type="wicri:Area/Main/Merge">002882</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Ten-Year Follow-Up of Parkinson's Disease Patients Randomized to Initial Therapy with Ropinirole or Levodopa</title><author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>University of South Florida</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>University Hospital</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author><author><name sortKey="Korczyn, Amos D" sort="Korczyn, Amos D" uniqKey="Korczyn A" first="Amos D." last="Korczyn">Amos D. Korczyn</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Tel Aviv University Medical School</s1><s2>Ramat Aviv</s2><s3>ISR</s3><sZ>3 aut.</sZ></inist:fA14><country>Israël</country><wicri:noRegion>Tel Aviv University Medical School</wicri:noRegion></affiliation></author><author><name sortKey="Stoessl, A Jon" sort="Stoessl, A Jon" uniqKey="Stoessl A" first="A. Jon" last="Stoessl">A. Jon Stoessl</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>University of British Columbia</s1><s2>Vancouver, British Columbia</s2><s3>CAN</s3><sZ>4 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of British Columbia</wicri:noRegion></affiliation></author><author><name sortKey="Watts, Ray L" sort="Watts, Ray L" uniqKey="Watts R" first="Ray L." last="Watts">Ray L. Watts</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>University of Alabama</s1><s2>Birmingham, Alabama</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Alabama</region></placeName></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University of Innsbruck</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>6 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>University of Innsbruck</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author><author><name sortKey="De Deyn, Peter P" sort="De Deyn, Peter P" uniqKey="De Deyn P" first="Peter P." last="De Deyn">Peter P. De Deyn</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>University of Antwerp</s1><s2>Antwerp</s2><s3>BEL</s3><sZ>7 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName><orgName type="university">Université d'Anvers</orgName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>8 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto Western Hospital</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Complication</term><term>Dyskinesia</term><term>Human</term><term>Levodopa</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Ropinirole</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Dyskinésie</term><term>Pathologie du système nerveux</term><term>Homme</term><term>Traitement</term><term>Ropinirole</term><term>Lévodopa</term><term>Complication</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In a 5-year, double-blind study, subjects with Parkinson's disease (PD) who were randomized to initial treatment with ropinirole had a significantly lower incidence of dyskinesia compared with subjects randomized to levodopa, although Unified Parkinson's Disease Rating Scale (UPDRS) motor scores were significantly more improved in the levodopa group. Subjects who completed the original study were eligible to participate in a long-term extension study conducted according to an open, naturalistic design and were evaluated approximately every 6 months until they had been followed for a total of 10 years. Comparing subjects randomized to initial treatment with ropinirole (n = 42) and levodopa (n = 27), the incidence of dyskinesia was significantly lower in the ropinirole group (adjusted odds ratio [OR] = 0.3; 95% confidence interval [CI]: 0.1, 1.0; P = 0.046) and the median time to dyskinesia was significantly longer (adjusted hazard ratio = 0.4; 95% CI: 0.2, 0.8; P = 0.007). The incidence of at least moderate wearing off ("off' time ≥ 26% of the awake day) was also significantly lower in the ropinirole group (adjusted OR = 0.3; 95% Cl. 0.09, 0.03; P = 0.03). There were no significant differences change in UPDRS activities of daily living or motor scores, o scores for the 39-item PD questionnaire, Clinical Global Im pression, or the Epworth Sleepiness Scale. Early treatment decisions for individual patients depend largely on the antici pated risk of side effects and long-term complications. Both ropinirole and levodopa are viable treatment options in eaily PD.</div></front></TEI><affiliations><list><country><li>Autriche</li><li>Belgique</li><li>Canada</li><li>France</li><li>Israël</li><li>États-Unis</li></country><region><li>Alabama</li><li>Floride</li><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li><li>Province d'Anvers</li><li>Région flamande</li><li>Tyrol (Land)</li></region><settlement><li>Anvers</li><li>Innsbruck</li><li>Tampa</li><li>Toulouse</li></settlement><orgName><li>Université d'Anvers</li><li>Université de Floride du Sud</li><li>Université de médecine d'Innsbruck</li></orgName></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name></region><name sortKey="Watts, Ray L" sort="Watts, Ray L" uniqKey="Watts R" first="Ray L." last="Watts">Ray L. Watts</name></country><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name></region></country><country name="Israël"><noRegion><name sortKey="Korczyn, Amos D" sort="Korczyn, Amos D" uniqKey="Korczyn A" first="Amos D." last="Korczyn">Amos D. Korczyn</name></noRegion></country><country name="Canada"><noRegion><name sortKey="Stoessl, A Jon" sort="Stoessl, A Jon" uniqKey="Stoessl A" first="A. Jon" last="Stoessl">A. Jon Stoessl</name></noRegion><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name></country><country name="Autriche"><region name="Tyrol (Land)"><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name></region></country><country name="Belgique"><region name="Région flamande"><name sortKey="De Deyn, Peter P" sort="De Deyn, Peter P" uniqKey="De Deyn P" first="Peter P." last="De Deyn">Peter P. De Deyn</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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