Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa
Identifieur interne : 000F35 ( Istex/Corpus ); précédent : 000F34; suivant : 000F36Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa
Auteurs : Olivier Rascol ; David J. Brooks ; Amos D. Korczyn ; Peter P. De Deyn ; Carl E. Clarke ; Anthony E. Lang ; Mona AbdallaSource :
- Movement Disorders [ 0885-3185 ] ; 2006-11.
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- KwdEn :
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
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DOI: 10.1002/mds.20988
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ISTEX:BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5Le document en format XML
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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><istex><corpusName>wiley</corpusName><author><json:item><name>Olivier Rascol MD, PhD</name><affiliations><json:string>Clinical Investigation Centre, Department of Pharmacology and INSERM U455, Toulouse Hospital, Toulouse, France</json:string></affiliations></json:item><json:item><name>David J. Brooks MD</name><affiliations><json:string>Faculty of Medicine, Imperial College, Hammersmith Hospital, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Amos D. Korczyn MD</name><affiliations><json:string>Tel Aviv University Medical School, Tel Aviv, Israel</json:string></affiliations></json:item><json:item><name>Peter P. De Deyn MD</name><affiliations><json:string>Middelheim General Hospital, University of Antwerp, Antwerp, Belgium</json:string></affiliations></json:item><json:item><name>Carl E. Clarke MD</name><affiliations><json:string>University of Birmingham, Birmingham, United Kingdom</json:string></affiliations></json:item><json:item><name>Anthony E. Lang MD</name><affiliations><json:string>Department of Medicine (Neurology) University of Toronto, Toronto, Canada</json:string></affiliations></json:item><json:item><name>Mona Abdalla PhD</name><affiliations><json:string>London School of Hygiene and Tropical Medicine, London, United Kingdom</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>ropinirole</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>levodopa</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dyskinesia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item></subject><language><json:string>eng</json:string></language><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</abstract><qualityIndicators><score>6.683</score><pdfVersion>1.3</pdfVersion><pdfPageSize>594 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1469</abstractCharCount><pdfWordCount>4163</pdfWordCount><pdfCharCount>26942</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>210</abstractWordCount></qualityIndicators><title>Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa</title><genre><json:string>Serial article</json:string></genre><host><volume>21</volume><pages><total>7</total><last>1850</last><first>1844</first></pages><issn><json:string>0885-3185</json:string></issn><issue>11</issue><subject><json:item><value>Research Article</value></json:item></subject><genre></genre><language><json:string>unknown</json:string></language><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1002/mds.20988</json:string></doi><id>BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5/fulltext/tei"><teiHeader type="text"><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Wiley Subscription Services, Inc., A Wiley Company</p></availability><date>2006</date></publicationStmt><notesStmt><note>GlaxoSmithKline Research and Development</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa</title><author><persName><forename type="first">Olivier</forename><surname>Rascol</surname><roleName type="degree">MD, PhD</roleName></persName><note type="correspondence"><p>Correspondence: Faculty of Medicine, Department of Clinical Pharmacology, 37 allées Jules‐Guesde, 31000 Toulouse, France</p></note><affiliation>Clinical Investigation Centre, Department of Pharmacology and INSERM U455, Toulouse Hospital, Toulouse, France</affiliation></author><author><persName><forename type="first">David J.</forename><surname>Brooks</surname><roleName type="degree">MD</roleName></persName><affiliation>Faculty of Medicine, Imperial College, Hammersmith Hospital, London, United Kingdom</affiliation></author><author><persName><forename type="first">Amos D.</forename><surname>Korczyn</surname><roleName type="degree">MD</roleName></persName><affiliation>Tel Aviv University Medical School, Tel Aviv, Israel</affiliation></author><author><persName><forename type="first">Peter P.</forename><surname>De Deyn</surname><roleName type="degree">MD</roleName></persName><affiliation>Middelheim General Hospital, University of Antwerp, Antwerp, Belgium</affiliation></author><author><persName><forename type="first">Carl E.</forename><surname>Clarke</surname><roleName type="degree">MD</roleName></persName><affiliation>University of Birmingham, Birmingham, United Kingdom</affiliation></author><author><persName><forename type="first">Anthony E.</forename><surname>Lang</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Medicine (Neurology) University of Toronto, Toronto, Canada</affiliation></author><author><persName><forename type="first">Mona</forename><surname>Abdalla</surname><roleName type="degree">PhD</roleName></persName><affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. 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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</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>ropinirole</term></item><item><term>levodopa</term></item><item><term>dyskinesia</term></item><item><term>Parkinson's disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-11-10">Received</change><change when="2006-02-23">Registration</change><change when="2006-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. 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type="organization"><unparsedAffiliation>Department of Medicine (Neurology) University of Toronto, Toronto, Canada</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="GB" type="organization"><unparsedAffiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">ropinirole</keyword><keyword xml:id="kwd2">levodopa</keyword><keyword xml:id="kwd3">dyskinesia</keyword><keyword xml:id="kwd4">Parkinson's disease</keyword></keywordGroup><fundingInfo><fundingAgency>GlaxoSmithKline Research and Development</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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; <i>P</i> < 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; <i>P</i> = 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</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Development of dyskinesias in a 5‐year trial of ropinirole and L‐dopa</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Trial of Ropinirole and L‐Dopa</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Development of dyskinesias in a 5‐year trial of ropinirole and</title></titleInfo><name type="personal"><namePart type="given">Olivier</namePart><namePart type="family">Rascol</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Clinical Investigation Centre, Department of Pharmacology and INSERM U455, Toulouse Hospital, Toulouse, France</affiliation><description>Correspondence: Faculty of Medicine, Department of Clinical Pharmacology, 37 allées Jules‐Guesde, 31000 Toulouse, France</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David J.</namePart><namePart type="family">Brooks</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Faculty of Medicine, Imperial College, Hammersmith Hospital, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Amos D.</namePart><namePart type="family">Korczyn</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Tel Aviv University Medical School, Tel Aviv, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Peter P.</namePart><namePart type="family">De Deyn</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Middelheim General Hospital, University of Antwerp, Antwerp, Belgium</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carl E.</namePart><namePart type="family">Clarke</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>University of Birmingham, Birmingham, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Anthony E.</namePart><namePart type="family">Lang</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Medicine (Neurology) University of Toronto, Toronto, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mona</namePart><namePart type="family">Abdalla</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>London School of Hygiene and Tropical Medicine, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2006-11</dateIssued><dateCaptured encoding="w3cdtf">2005-11-10</dateCaptured><dateValid encoding="w3cdtf">2006-02-23</dateValid><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">4</extent><extent unit="tables">3</extent><extent unit="references">19</extent><extent unit="words">4774</extent></physicalDescription><abstract 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</abstract><note type="funding">GlaxoSmithKline Research and Development</note><subject lang="en"><genre>Keywords</genre><topic>ropinirole</topic><topic>levodopa</topic><topic>dyskinesia</topic><topic>Parkinson's disease</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>21</number></detail><detail type="issue"><caption>no.</caption><number>11</number></detail><extent unit="pages"><start>1844</start><end>1850</end><total>7</total></extent></part></relatedItem><identifier type="istex">BB8195542AFAD4DEAA1B2B80E3E692FA9AD193D5</identifier><identifier type="DOI">10.1002/mds.20988</identifier><identifier type="ArticleID">MDS20988</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2006 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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