Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa
Identifieur interne : 000371 ( France/Analysis ); précédent : 000370; suivant : 000372Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa
Auteurs : Olivier Rascol [France] ; David J. Brooks [Royaume-Uni] ; Amos D. Korczyn [Israël] ; Peter P. De Deyn [Belgique] ; Carl E. Clarke [Royaume-Uni] ; Anthony E. Lang [Canada] ; Mona Abdalla [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-11.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Antiparkinson Agents (adverse effects), Confidence Intervals, Drug Therapy, Combination, Dyskinesia, Dyskinesia, Drug-Induced (etiology), Dyskinesia, Drug-Induced (mortality), Humans, Indoles (adverse effects), Levodopa, Levodopa (adverse effects), Longitudinal Studies, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson Disease (epidemiology), Parkinson Disease (mortality), Parkinson disease, Parkinson's disease, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Ropinirole, Survival Analysis, dyskinesia, levodopa, ropinirole.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Indoles, Levodopa.
- drug therapy : Parkinson Disease.
- epidemiology : Parkinson Disease.
- etiology : Dyskinesia, Drug-Induced.
- mortality : Dyskinesia, Drug-Induced, Parkinson Disease.
- Confidence Intervals, Drug Therapy, Combination, Humans, Longitudinal Studies, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Survival Analysis.
Abstract
A 5‐year trial of ropinirole and levodopa in early Parkinson's disease showed that ropinirole is associated with reduced incidence of dyskinesias. This post hoc analysis investigated whether the dyskinesia‐sparing benefit of ropinirole is lost when levodopa is added to the regimen and evaluated other risk factors for developing dyskinesias. Patients receiving levodopa had a significantly higher risk of dyskinesias than those taking ropinirole monotherapy (hazard ratio [HR], 6.67; 95% confidence interval [CI], 3.23–14.29; P < 0.001). When patients randomized to ropinirole were treated with supplementary levodopa, the development of dyskinesias was not significantly different from that in those receiving levodopa from the start (HR, 0.80; 95% CI, 0.48–1.33; P = 0.39). However, the onset of dyskinesias was delayed by around 3 years compared with levodopa monotherapy. Adjusted analyses taking into account baseline and on‐treatment factors that influenced use of supplementary levodopa or the development of dyskinesias produced similar results. In conclusion, the risk of developing dyskinesias during maintained initial ropinirole monotherapy is very low. Only once levodopa is added does the risk substantially change. Early use of ropinirole postpones the onset of dyskinesias, but these benefits decline when levodopa therapy is started, with no evidence of a subsequent rapid “catch‐up” or a persisting preventive effect. © 2006 Movement Disorder Society
Url:
DOI: 10.1002/mds.20988
Affiliations:
- Belgique, Canada, France, Israël, Royaume-Uni
- Angleterre, Grand Londres, Midi-Pyrénées, Midlands de l'Ouest, Ontario, Province d'Anvers
- Anvers, Birmingham, Londres, Toronto, Toulouse
- Université Toulouse III - Paul Sabatier, Université d'Anvers, Université de Birmingham, Université de Toronto, Université de Toulouse
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ISTEX:BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5Le document en format XML
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Brooks</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Medicine, Imperial College, Hammersmith Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></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"><country xml:lang="fr">Israël</country><wicri:regionArea>Tel Aviv University Medical School, Tel Aviv</wicri:regionArea><wicri:noRegion>Tel Aviv</wicri:noRegion></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. 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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2006-11">2006-11</date><biblScope unit="vol">21</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="1844">1844</biblScope><biblScope unit="page" to="1850">1850</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5</idno><idno type="DOI">10.1002/mds.20988</idno><idno type="ArticleID">MDS20988</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents (adverse effects)</term><term>Confidence Intervals</term><term>Drug Therapy, Combination</term><term>Dyskinesia</term><term>Dyskinesia, Drug-Induced (etiology)</term><term>Dyskinesia, Drug-Induced (mortality)</term><term>Humans</term><term>Indoles (adverse effects)</term><term>Levodopa</term><term>Levodopa (adverse effects)</term><term>Longitudinal Studies</term><term>Nervous system diseases</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (epidemiology)</term><term>Parkinson Disease (mortality)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Predictive Value of Tests</term><term>Proportional Hazards Models</term><term>Risk Factors</term><term>Ropinirole</term><term>Survival Analysis</term><term>dyskinesia</term><term>levodopa</term><term>ropinirole</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Indoles</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Confidence Intervals</term><term>Drug Therapy, Combination</term><term>Humans</term><term>Longitudinal Studies</term><term>Predictive Value of Tests</term><term>Proportional Hazards Models</term><term>Risk Factors</term><term>Survival Analysis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dyskinésie</term><term>Lévodopa</term><term>Parkinson maladie</term><term>Ropinirole</term><term>Système nerveux pathologie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A 5‐year trial of ropinirole and levodopa in early Parkinson's disease showed that ropinirole is associated with reduced incidence of dyskinesias. This post hoc analysis investigated whether the dyskinesia‐sparing benefit of ropinirole is lost when levodopa is added to the regimen and evaluated other risk factors for developing dyskinesias. Patients receiving levodopa had a significantly higher risk of dyskinesias than those taking ropinirole monotherapy (hazard ratio [HR], 6.67; 95% confidence interval [CI], 3.23–14.29; P < 0.001). When patients randomized to ropinirole were treated with supplementary levodopa, the development of dyskinesias was not significantly different from that in those receiving levodopa from the start (HR, 0.80; 95% CI, 0.48–1.33; P = 0.39). However, the onset of dyskinesias was delayed by around 3 years compared with levodopa monotherapy. Adjusted analyses taking into account baseline and on‐treatment factors that influenced use of supplementary levodopa or the development of dyskinesias produced similar results. In conclusion, the risk of developing dyskinesias during maintained initial ropinirole monotherapy is very low. Only once levodopa is added does the risk substantially change. Early use of ropinirole postpones the onset of dyskinesias, but these benefits decline when levodopa therapy is started, with no evidence of a subsequent rapid “catch‐up” or a persisting preventive effect. © 2006 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Canada</li><li>France</li><li>Israël</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Midi-Pyrénées</li><li>Midlands de l'Ouest</li><li>Ontario</li><li>Province d'Anvers</li></region><settlement><li>Anvers</li><li>Birmingham</li><li>Londres</li><li>Toronto</li><li>Toulouse</li></settlement><orgName><li>Université Toulouse III - Paul Sabatier</li><li>Université d'Anvers</li><li>Université de Birmingham</li><li>Université de Toronto</li><li>Université de Toulouse</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Brooks, David J" sort="Brooks, David J" uniqKey="Brooks D" first="David J." last="Brooks">David J. Brooks</name></region><name sortKey="Abdalla, Mona" sort="Abdalla, Mona" uniqKey="Abdalla M" first="Mona" last="Abdalla">Mona Abdalla</name><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E." last="Clarke">Carl E. Clarke</name></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="Belgique"><region name="Province d'Anvers"><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><country name="Canada"><region name="Ontario"><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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