ParkinsonCanadaV1, PascalFrancis, Corpus, bibRecord, 000C96

A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa

Identifieur interne : 000C96 ( PascalFrancis/Corpus ); précédent : 000C95; suivant : 000C97

A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa

Auteurs : O. Rascol ; D. J. Brooks ; A. D. Korczyn ; P. P. De Deyn ; C. E. Clarke ; A. E. Lang

Source :

The New England journal of medicine [ 0028-4793 ] ; 2000.

RBID : Pascal:00-0286455

Descripteurs français

Pascal (Inist)
- Parkinson maladie, Homme, Précoce, Randomisation, Etude double insu, Efficacité traitement, Ropinirole, Antiparkinsonien, Agoniste, Récepteur dopaminergique D2, Stimulant dopaminergique, Traitement, Dopa, Chimiothérapie, Prévention, Dyskinésie, Etude comparative, Aminoacide.

English descriptors

KwdEn :
- Agonist, Aminoacid, Antiparkinson agent, Chemotherapy, Comparative study, D2 Dopamine receptor, Dopa, Dopamine agonist, Double blind study, Dyskinesia, Early, Human, Parkinson disease, Prevention, Randomization, Ropinirole, Treatment, Treatment efficiency.

Abstract

Background There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist. Methods In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia. Results Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P<0.001). At five years, the cumulative incidence of dyskinesia (excluding the three patients who had dyskinesia at base line), regardless of levodopa supplementation, was 20 percent (36 of 177 patients) in the ropinirole group and 45 percent (40 of 88 patients) in the levodopa group. There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study. Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group (27 percent) and 29 of 89 patients in the levodopa group (33 percent). The mean (±SD) daily doses given by the end of the study were 16.5±6.6 mg of ropinirole (plus 427±221 mg of levodopa in patients who received supplementation) and 753±398 mg of levodopa (including supplements). Conclusions Early Parkinson's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

A01	`01`	`1`		`@0 0028-4793`
A02	`01`			`@0 NEJMAG`
A03		`1`		`@0 N. Engl. j. med.`
A05				`@2 342`
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A08	`01`	`1`	`ENG`	`@1 A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa`
A11	`01`	`1`		`@1 RASCOL (O.)`
A11	`02`	`1`		`@1 BROOKS (D. J.)`
A11	`03`	`1`		`@1 KORCZYN (A. D.)`
A11	`04`	`1`		`@1 DE DEYN (P. P.)`
A11	`05`	`1`		`@1 CLARKE (C. E.)`
A11	`06`	`1`		`@1 LANG (A. E.)`
A14	`01`			`@1 Clinical Investigation Center, Neuropharmacology Unit, INSERM Unité 455, University Hospital @2 Toulouse @3 FRA @Z 1 aut.`
A14	`02`			`@1 Division of Neuroscience, Imperial College School of Medicine, Hammersmith Hospital @2 London @3 GBR @Z 2 aut.`
A14	`03`			`@1 Department of Neurology, Tel Aviv University Medical School @2 Ramat Aviv @3 ISR @Z 3 aut.`
A14	`04`			`@1 Department of Neurology, General Hospital Middelheim, Born-Bunge Foundation, and University of Antwerp @2 Antwerp @3 BEL @Z 4 aut.`
A14	`05`			`@1 Department of Neurology, University of Birmingham @2 Birmingham @3 GBR @Z 5 aut.`
A14	`06`			`@1 Department of Medicine (Neurology), University of Toronto and Toronto Western Hospital @2 Toronto @3 CAN @Z 6 aut.`
A17	`01`	`1`		`@1 056 Study Group @3 INC`
A20				`@1 1484-1491`
A21				`@1 2000`
A23	`01`			`@0 ENG`
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A44				`@0 0000 @1 © 2000 INIST-CNRS. All rights reserved.`
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A47	`01`	`1`		`@0 00-0286455`
A60				`@1 P`
A61				`@0 A`
A64	`01`	`1`		`@0 The New England journal of medicine`
A66	`01`			`@0 USA`
C01	`01`		`ENG`	@0 Background There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist. Methods In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia. Results Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P<0.001). At five years, the cumulative incidence of dyskinesia (excluding the three patients who had dyskinesia at base line), regardless of levodopa supplementation, was 20 percent (36 of 177 patients) in the ropinirole group and 45 percent (40 of 88 patients) in the levodopa group. There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study. Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group (27 percent) and 29 of 89 patients in the levodopa group (33 percent). The mean (±SD) daily doses given by the end of the study were 16.5±6.6 mg of ropinirole (plus 427±221 mg of levodopa in patients who received supplementation) and 753±398 mg of levodopa (including supplements). Conclusions Early Parkinson's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.
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C03	`02`	`X`	`SPA`	`@0 Hombre @5 02`
C03	`03`	`X`	`FRE`	`@0 Précoce @5 03`
C03	`03`	`X`	`ENG`	`@0 Early @5 03`
C03	`03`	`X`	`SPA`	`@0 Precoz @5 03`
C03	`04`	`X`	`FRE`	`@0 Randomisation @5 04`
C03	`04`	`X`	`ENG`	`@0 Randomization @5 04`
C03	`04`	`X`	`SPA`	`@0 Aleatorización @5 04`
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C03	`05`	`X`	`ENG`	`@0 Double blind study @5 05`
C03	`05`	`X`	`SPA`	`@0 Estudio doble ciego @5 05`
C03	`06`	`X`	`FRE`	`@0 Efficacité traitement @5 06`
C03	`06`	`X`	`ENG`	`@0 Treatment efficiency @5 06`
C03	`06`	`X`	`SPA`	`@0 Eficacia tratamiento @5 06`
C03	`07`	`X`	`FRE`	`@0 Ropinirole @2 NK @2 FR @5 07`
C03	`07`	`X`	`ENG`	`@0 Ropinirole @2 NK @2 FR @5 07`
C03	`07`	`X`	`SPA`	`@0 Ropinirol @2 NK @2 FR @5 07`
C03	`08`	`X`	`FRE`	`@0 Antiparkinsonien @5 08`
C03	`08`	`X`	`ENG`	`@0 Antiparkinson agent @5 08`
C03	`08`	`X`	`SPA`	`@0 Antiparkinsoniano @5 08`
C03	`09`	`X`	`FRE`	`@0 Agoniste @5 09`
C03	`09`	`X`	`ENG`	`@0 Agonist @5 09`
C03	`09`	`X`	`SPA`	`@0 Agonista @5 09`
C03	`10`	`X`	`FRE`	`@0 Récepteur dopaminergique D2 @5 10`
C03	`10`	`X`	`ENG`	`@0 D2 Dopamine receptor @5 10 @6 «D2» Dopamine receptor`
C03	`10`	`X`	`SPA`	`@0 Receptor dopaminérgico D2 @5 10`
C03	`11`	`X`	`FRE`	`@0 Stimulant dopaminergique @5 11`
C03	`11`	`X`	`ENG`	`@0 Dopamine agonist @5 11`
C03	`11`	`X`	`SPA`	`@0 Estimulante dopaminérgico @5 11`
C03	`12`	`X`	`FRE`	`@0 Traitement @5 12`
C03	`12`	`X`	`ENG`	`@0 Treatment @5 12`
C03	`12`	`X`	`SPA`	`@0 Tratamiento @5 12`
C03	`13`	`X`	`FRE`	`@0 Dopa @2 NK @2 FR @5 13`
C03	`13`	`X`	`ENG`	`@0 Dopa @2 NK @2 FR @5 13`
C03	`13`	`X`	`SPA`	`@0 Dopa @2 NK @2 FR @5 13`
C03	`14`	`X`	`FRE`	`@0 Chimiothérapie @5 17`
C03	`14`	`X`	`ENG`	`@0 Chemotherapy @5 17`
C03	`14`	`X`	`SPA`	`@0 Quimioterapia @5 17`
C03	`15`	`X`	`FRE`	`@0 Prévention @5 18`
C03	`15`	`X`	`ENG`	`@0 Prevention @5 18`
C03	`15`	`X`	`SPA`	`@0 Prevención @5 18`
C03	`16`	`X`	`FRE`	`@0 Dyskinésie @5 19`
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C03	`17`	`X`	`FRE`	`@0 Etude comparative @5 20`
C03	`17`	`X`	`ENG`	`@0 Comparative study @5 20`
C03	`17`	`X`	`SPA`	`@0 Estudio comparativo @5 20`
C03	`18`	`X`	`FRE`	`@0 Aminoacide @5 33`
C03	`18`	`X`	`ENG`	`@0 Aminoacid @5 33`
C03	`18`	`X`	`SPA`	`@0 Aminoácido @5 33`
C07	`01`	`X`	`FRE`	`@0 Système nerveux pathologie @5 37`
C07	`01`	`X`	`ENG`	`@0 Nervous system diseases @5 37`
C07	`01`	`X`	`SPA`	`@0 Sistema nervioso patología @5 37`
C07	`02`	`X`	`FRE`	`@0 Système nerveux central pathologie @5 38`
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C07	`04`	`X`	`FRE`	`@0 Extrapyramidal syndrome @5 40`
C07	`04`	`X`	`ENG`	`@0 Extrapyramidal syndrome @5 40`
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C07	`05`	`X`	`SPA`	`@0 Enfermedad degenerativa @5 41`
N21				`@1 192`

Format Inist (serveur)

NO :	PASCAL 00-0286455 INIST
ET :	A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa
AU :	RASCOL (O.); BROOKS (D. J.); KORCZYN (A. D.); DE DEYN (P. P.); CLARKE (C. E.); LANG (A. E.)
AF :	Clinical Investigation Center, Neuropharmacology Unit, INSERM Unité 455, University Hospital/Toulouse/France (1 aut.); Division of Neuroscience, Imperial College School of Medicine, Hammersmith Hospital/London/Royaume-Uni (2 aut.); Department of Neurology, Tel Aviv University Medical School/Ramat Aviv/Israël (3 aut.); Department of Neurology, General Hospital Middelheim, Born-Bunge Foundation, and University of Antwerp/Antwerp/Belgique (4 aut.); Department of Neurology, University of Birmingham/Birmingham/Royaume-Uni (5 aut.); Department of Medicine (Neurology), University of Toronto and Toronto Western Hospital/Toronto/Canada (6 aut.)
DT :	Publication en série; Niveau analytique
SO :	The New England journal of medicine; ISSN 0028-4793; Coden NEJMAG; Etats-Unis; Da. 2000; Vol. 342; No. 20; Pp. 1484-1491; Bibl. 31 ref.
LA :	Anglais
EA :	Background There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist. Methods In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia. Results Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P<0.001). At five years, the cumulative incidence of dyskinesia (excluding the three patients who had dyskinesia at base line), regardless of levodopa supplementation, was 20 percent (36 of 177 patients) in the ropinirole group and 45 percent (40 of 88 patients) in the levodopa group. There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study. Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group (27 percent) and 29 of 89 patients in the levodopa group (33 percent). The mean (±SD) daily doses given by the end of the study were 16.5±6.6 mg of ropinirole (plus 427±221 mg of levodopa in patients who received supplementation) and 753±398 mg of levodopa (including supplements). Conclusions Early Parkinson's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.
CC :	002B02B06
FD :	Parkinson maladie; Homme; Précoce; Randomisation; Etude double insu; Efficacité traitement; Ropinirole; Antiparkinsonien; Agoniste; Récepteur dopaminergique D2; Stimulant dopaminergique; Traitement; Dopa; Chimiothérapie; Prévention; Dyskinésie; Etude comparative; Aminoacide
FG :	Système nerveux pathologie; Système nerveux central pathologie; Encéphale pathologie; Extrapyramidal syndrome; Maladie dégénérative
ED :	Parkinson disease; Human; Early; Randomization; Double blind study; Treatment efficiency; Ropinirole; Antiparkinson agent; Agonist; D2 Dopamine receptor; Dopamine agonist; Treatment; Dopa; Chemotherapy; Prevention; Dyskinesia; Comparative study; Aminoacid
EG :	Nervous system diseases; Central nervous system disease; Cerebral disorder; Extrapyramidal syndrome; Degenerative disease
SD :	Parkinson enfermedad; Hombre; Precoz; Aleatorización; Estudio doble ciego; Eficacia tratamiento; Ropinirol; Antiparkinsoniano; Agonista; Receptor dopaminérgico D2; Estimulante dopaminérgico; Tratamiento; Dopa; Quimioterapia; Prevención; Disquinesia; Estudio comparativo; Aminoácido
LO :	INIST-6013.354000087341300040
ID :	00-0286455

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Agonist</term>
<term>Aminoacid</term>
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<term>Chemotherapy</term>
<term>Comparative study</term>
<term>D2 Dopamine receptor</term>
<term>Dopa</term>
<term>Dopamine agonist</term>
<term>Double blind study</term>
<term>Dyskinesia</term>
<term>Early</term>
<term>Human</term>
<term>Parkinson disease</term>
<term>Prevention</term>
<term>Randomization</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Homme</term>
<term>Précoce</term>
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<term>Etude double insu</term>
<term>Efficacité traitement</term>
<term>Ropinirole</term>
<term>Antiparkinsonien</term>
<term>Agoniste</term>
<term>Récepteur dopaminergique D2</term>
<term>Stimulant dopaminergique</term>
<term>Traitement</term>
<term>Dopa</term>
<term>Chimiothérapie</term>
<term>Prévention</term>
<term>Dyskinésie</term>
<term>Etude comparative</term>
<term>Aminoacide</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Background There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist. Methods In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia. Results Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P<0.001). At five years, the cumulative incidence of dyskinesia (excluding the three patients who had dyskinesia at base line), regardless of levodopa supplementation, was 20 percent (36 of 177 patients) in the ropinirole group and 45 percent (40 of 88 patients) in the levodopa group. There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study. Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group (27 percent) and 29 of 89 patients in the levodopa group (33 percent). The mean (±SD) daily doses given by the end of the study were 16.5±6.6 mg of ropinirole (plus 427±221 mg of levodopa in patients who received supplementation) and 753±398 mg of levodopa (including supplements). Conclusions Early Parkinson's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.</div>
</front>
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<fA02 i1="01"><s0>NEJMAG</s0>
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<fA03 i2="1"><s0>N. Engl. j. med.</s0>
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<fA06><s2>20</s2>
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<fA08 i1="01" i2="1" l="ENG"><s1>A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa</s1>
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<fA11 i1="01" i2="1"><s1>RASCOL (O.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>BROOKS (D. J.)</s1>
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<fA11 i1="03" i2="1"><s1>KORCZYN (A. D.)</s1>
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<fA11 i1="04" i2="1"><s1>DE DEYN (P. P.)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>CLARKE (C. E.)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>LANG (A. E.)</s1>
</fA11>
<fA14 i1="01"><s1>Clinical Investigation Center, Neuropharmacology Unit, INSERM Unité 455, University Hospital</s1>
<s2>Toulouse</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Division of Neuroscience, Imperial College School of Medicine, Hammersmith Hospital</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Department of Neurology, Tel Aviv University Medical School</s1>
<s2>Ramat Aviv</s2>
<s3>ISR</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Department of Neurology, General Hospital Middelheim, Born-Bunge Foundation, and University of Antwerp</s1>
<s2>Antwerp</s2>
<s3>BEL</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Department of Neurology, University of Birmingham</s1>
<s2>Birmingham</s2>
<s3>GBR</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Department of Medicine (Neurology), University of Toronto and Toronto Western Hospital</s1>
<s2>Toronto</s2>
<s3>CAN</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA17 i1="01" i2="1"><s1>056 Study Group</s1>
<s3>INC</s3>
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<fA64 i1="01" i2="1"><s0>The New England journal of medicine</s0>
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<fA66 i1="01"><s0>USA</s0>
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<fC01 i1="01" l="ENG"><s0>Background There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist. Methods In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia. Results Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P<0.001). At five years, the cumulative incidence of dyskinesia (excluding the three patients who had dyskinesia at base line), regardless of levodopa supplementation, was 20 percent (36 of 177 patients) in the ropinirole group and 45 percent (40 of 88 patients) in the levodopa group. There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study. Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group (27 percent) and 29 of 89 patients in the levodopa group (33 percent). The mean (±SD) daily doses given by the end of the study were 16.5±6.6 mg of ropinirole (plus 427±221 mg of levodopa in patients who received supplementation) and 753±398 mg of levodopa (including supplements). Conclusions Early Parkinson's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.</s0>
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<fC03 i1="05" i2="X" l="ENG"><s0>Double blind study</s0>
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</fC03>
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<s5>06</s5>
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<s2>NK</s2>
<s2>FR</s2>
<s5>07</s5>
</fC03>
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<s2>FR</s2>
<s5>07</s5>
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<fC03 i1="08" i2="X" l="FRE"><s0>Antiparkinsonien</s0>
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<fC03 i1="08" i2="X" l="ENG"><s0>Antiparkinson agent</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Antiparkinsoniano</s0>
<s5>08</s5>
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<fC03 i1="09" i2="X" l="FRE"><s0>Agoniste</s0>
<s5>09</s5>
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<fC03 i1="10" i2="X" l="FRE"><s0>Récepteur dopaminergique D2</s0>
<s5>10</s5>
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<fC03 i1="10" i2="X" l="ENG"><s0>D2 Dopamine receptor</s0>
<s5>10</s5>
<s6>«D2» Dopamine receptor</s6>
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<s5>10</s5>
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<s5>11</s5>
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<fC03 i1="11" i2="X" l="SPA"><s0>Estimulante dopaminérgico</s0>
<s5>11</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE"><s0>Traitement</s0>
<s5>12</s5>
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<s5>13</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG"><s0>Dopa</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>13</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA"><s0>Dopa</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>13</s5>
</fC03>
<fC03 i1="14" i2="X" l="FRE"><s0>Chimiothérapie</s0>
<s5>17</s5>
</fC03>
<fC03 i1="14" i2="X" l="ENG"><s0>Chemotherapy</s0>
<s5>17</s5>
</fC03>
<fC03 i1="14" i2="X" l="SPA"><s0>Quimioterapia</s0>
<s5>17</s5>
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<fC03 i1="15" i2="X" l="FRE"><s0>Prévention</s0>
<s5>18</s5>
</fC03>
<fC03 i1="15" i2="X" l="ENG"><s0>Prevention</s0>
<s5>18</s5>
</fC03>
<fC03 i1="15" i2="X" l="SPA"><s0>Prevención</s0>
<s5>18</s5>
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<fC03 i1="16" i2="X" l="FRE"><s0>Dyskinésie</s0>
<s5>19</s5>
</fC03>
<fC03 i1="16" i2="X" l="ENG"><s0>Dyskinesia</s0>
<s5>19</s5>
</fC03>
<fC03 i1="16" i2="X" l="SPA"><s0>Disquinesia</s0>
<s5>19</s5>
</fC03>
<fC03 i1="17" i2="X" l="FRE"><s0>Etude comparative</s0>
<s5>20</s5>
</fC03>
<fC03 i1="17" i2="X" l="ENG"><s0>Comparative study</s0>
<s5>20</s5>
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<fC03 i1="17" i2="X" l="SPA"><s0>Estudio comparativo</s0>
<s5>20</s5>
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<fC03 i1="18" i2="X" l="FRE"><s0>Aminoacide</s0>
<s5>33</s5>
</fC03>
<fC03 i1="18" i2="X" l="ENG"><s0>Aminoacid</s0>
<s5>33</s5>
</fC03>
<fC03 i1="18" i2="X" l="SPA"><s0>Aminoácido</s0>
<s5>33</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0>
<s5>37</s5>
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<s5>37</s5>
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<s5>38</s5>
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<fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>38</s5>
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<fC07 i1="03" i2="X" l="FRE"><s0>Encéphale pathologie</s0>
<s5>39</s5>
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<s5>39</s5>
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<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0>
<s5>40</s5>
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<fC07 i1="04" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0>
<s5>40</s5>
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<fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0>
<s5>41</s5>
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<s5>41</s5>
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<fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0>
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<server><NO>PASCAL 00-0286455 INIST</NO>
<ET>A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa</ET>
<AU>RASCOL (O.); BROOKS (D. J.); KORCZYN (A. D.); DE DEYN (P. P.); CLARKE (C. E.); LANG (A. E.)</AU>
<AF>Clinical Investigation Center, Neuropharmacology Unit, INSERM Unité 455, University Hospital/Toulouse/France (1 aut.); Division of Neuroscience, Imperial College School of Medicine, Hammersmith Hospital/London/Royaume-Uni (2 aut.); Department of Neurology, Tel Aviv University Medical School/Ramat Aviv/Israël (3 aut.); Department of Neurology, General Hospital Middelheim, Born-Bunge Foundation, and University of Antwerp/Antwerp/Belgique (4 aut.); Department of Neurology, University of Birmingham/Birmingham/Royaume-Uni (5 aut.); Department of Medicine (Neurology), University of Toronto and Toronto Western Hospital/Toronto/Canada (6 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>The New England journal of medicine; ISSN 0028-4793; Coden NEJMAG; Etats-Unis; Da. 2000; Vol. 342; No. 20; Pp. 1484-1491; Bibl. 31 ref.</SO>
<LA>Anglais</LA>
<EA>Background There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist. Methods In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia. Results Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P<0.001). At five years, the cumulative incidence of dyskinesia (excluding the three patients who had dyskinesia at base line), regardless of levodopa supplementation, was 20 percent (36 of 177 patients) in the ropinirole group and 45 percent (40 of 88 patients) in the levodopa group. There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study. Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group (27 percent) and 29 of 89 patients in the levodopa group (33 percent). The mean (±SD) daily doses given by the end of the study were 16.5±6.6 mg of ropinirole (plus 427±221 mg of levodopa in patients who received supplementation) and 753±398 mg of levodopa (including supplements). Conclusions Early Parkinson's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary.</EA>
<CC>002B02B06</CC>
<FD>Parkinson maladie; Homme; Précoce; Randomisation; Etude double insu; Efficacité traitement; Ropinirole; Antiparkinsonien; Agoniste; Récepteur dopaminergique D2; Stimulant dopaminergique; Traitement; Dopa; Chimiothérapie; Prévention; Dyskinésie; Etude comparative; Aminoacide</FD>
<FG>Système nerveux pathologie; Système nerveux central pathologie; Encéphale pathologie; Extrapyramidal syndrome; Maladie dégénérative</FG>
<ED>Parkinson disease; Human; Early; Randomization; Double blind study; Treatment efficiency; Ropinirole; Antiparkinson agent; Agonist; D2 Dopamine receptor; Dopamine agonist; Treatment; Dopa; Chemotherapy; Prevention; Dyskinesia; Comparative study; Aminoacid</ED>
<EG>Nervous system diseases; Central nervous system disease; Cerebral disorder; Extrapyramidal syndrome; Degenerative disease</EG>
<SD>Parkinson enfermedad; Hombre; Precoz; Aleatorización; Estudio doble ciego; Eficacia tratamiento; Ropinirol; Antiparkinsoniano; Agonista; Receptor dopaminérgico D2; Estimulante dopaminérgico; Tratamiento; Dopa; Quimioterapia; Prevención; Disquinesia; Estudio comparativo; Aminoácido</SD>
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	La maladie de Parkinson au Canada (serveur d'exploration)
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La maladie de Parkinson au Canada (serveur d'exploration)

A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa

A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa

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