The Pharmacological Treatment for Uremic Restless Legs Syndrome: Evidence-Based Review
Identifieur interne : 001F08 ( Main/Exploration ); précédent : 001F07; suivant : 001F09The Pharmacological Treatment for Uremic Restless Legs Syndrome: Evidence-Based Review
Auteurs : Márcio Moyses De Oliveira [Brésil] ; Cristiane Fiquene Conti [Brésil] ; Juliana Spelta Valbuza [Brésil] ; Luciane Bizari Coin De Carvalho [Brésil] ; Gilmar Fernandes Do Prado [Brésil]Source :
- Movement disorders [ 0885-3185 ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
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Abstract
Restless legs syndrome (RLS) is a common and often misdiagnosed entity among the general population and it may be more common among dialysis patients, with an estimated prevalence of 6.6 to 21.5%. The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. This was a systematic review of randomized or quasi-randomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively, and adverse events associated with these treatments. Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement while asleep in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Only a few therapeutic trials on patients with uremia with RLS have been published, and there is insufficient scientific evidence to favor any specific therapeutic regimen for uremic-associated RLS. Therapy using levodopa, dopaminergic agonists, anticonvulsants, and clonidine tend to be effective, but further studies are needed.
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Paulo</region></placeName></affiliation></author><author><name sortKey="Spelta Valbuza, Juliana" sort="Spelta Valbuza, Juliana" uniqKey="Spelta Valbuza J" first="Juliana" last="Spelta Valbuza">Juliana Spelta Valbuza</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São 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aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Fiquene Conti, Cristiane" sort="Fiquene Conti, Cristiane" uniqKey="Fiquene Conti C" first="Cristiane" last="Fiquene Conti">Cristiane Fiquene Conti</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Spelta Valbuza, Juliana" sort="Spelta Valbuza, Juliana" uniqKey="Spelta Valbuza J" first="Juliana" last="Spelta Valbuza">Juliana Spelta Valbuza</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Brazilian Cochrane Center (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Coin De Carvalho, Luciane Bizari" sort="Coin De Carvalho, Luciane Bizari" uniqKey="Coin De Carvalho L" first="Luciane Bizari" last="Coin De Carvalho">Luciane Bizari Coin De Carvalho</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Fernandes Do Prado, Gilmar" sort="Fernandes Do Prado, Gilmar" uniqKey="Fernandes Do Prado G" first="Gilmar" last="Fernandes Do Prado">Gilmar Fernandes Do Prado</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Emergency Medicine and Evidence Based Medicine (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Sao Paulo Hospital Sleep Laboratory (UNIFESP), Universidade Federal de São Paulo</s1><s2>São Paulo</s2><s3>BRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></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="2010">2010</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>Chronic renal failure</term><term>Nervous system diseases</term><term>Renal failure</term><term>Restless legs syndrome</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Insuffisance rénale</term><term>Syndrome des jambes sans repos</term><term>Pathologie du système nerveux</term><term>Traitement</term><term>Insuffisance rénale chronique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Restless legs syndrome (RLS) is a common and often misdiagnosed entity among the general population and it may be more common among dialysis patients, with an estimated prevalence of 6.6 to 21.5%. The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. This was a systematic review of randomized or quasi-randomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively, and adverse events associated with these treatments. Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement while asleep in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Only a few therapeutic trials on patients with uremia with RLS have been published, and there is insufficient scientific evidence to favor any specific therapeutic regimen for uremic-associated RLS. Therapy using levodopa, dopaminergic agonists, anticonvulsants, and clonidine tend to be effective, but further studies are needed.</div></front></TEI><affiliations><list><country><li>Brésil</li></country><region><li>État de São Paulo</li></region><settlement><li>São Paulo</li></settlement></list><tree><country name="Brésil"><region name="État de São Paulo"><name sortKey="Moyses De Oliveira, Marcio" sort="Moyses De Oliveira, Marcio" uniqKey="Moyses De Oliveira M" first="Márcio" last="Moyses De Oliveira">Márcio Moyses De Oliveira</name></region><name sortKey="Coin De Carvalho, Luciane Bizari" sort="Coin De Carvalho, Luciane Bizari" uniqKey="Coin De Carvalho L" first="Luciane Bizari" last="Coin De Carvalho">Luciane Bizari Coin De Carvalho</name><name sortKey="Coin De Carvalho, Luciane Bizari" sort="Coin De Carvalho, Luciane Bizari" uniqKey="Coin De Carvalho L" first="Luciane Bizari" last="Coin De Carvalho">Luciane Bizari Coin De Carvalho</name><name sortKey="Fernandes Do Prado, Gilmar" sort="Fernandes Do Prado, Gilmar" uniqKey="Fernandes Do Prado G" first="Gilmar" last="Fernandes Do Prado">Gilmar Fernandes Do Prado</name><name sortKey="Fernandes Do Prado, Gilmar" sort="Fernandes Do Prado, Gilmar" uniqKey="Fernandes Do Prado G" first="Gilmar" last="Fernandes Do Prado">Gilmar Fernandes Do Prado</name><name sortKey="Fiquene Conti, Cristiane" sort="Fiquene Conti, Cristiane" uniqKey="Fiquene Conti C" first="Cristiane" last="Fiquene Conti">Cristiane Fiquene Conti</name><name sortKey="Fiquene Conti, Cristiane" sort="Fiquene Conti, Cristiane" uniqKey="Fiquene Conti C" first="Cristiane" last="Fiquene Conti">Cristiane Fiquene Conti</name><name sortKey="Fiquene Conti, Cristiane" sort="Fiquene Conti, Cristiane" uniqKey="Fiquene Conti C" first="Cristiane" last="Fiquene Conti">Cristiane Fiquene Conti</name><name sortKey="Moyses De Oliveira, Marcio" sort="Moyses De Oliveira, Marcio" uniqKey="Moyses De Oliveira M" first="Márcio" last="Moyses De Oliveira">Márcio Moyses De Oliveira</name><name sortKey="Moyses De Oliveira, Marcio" sort="Moyses De Oliveira, Marcio" uniqKey="Moyses De Oliveira M" first="Márcio" last="Moyses De Oliveira">Márcio Moyses De Oliveira</name><name sortKey="Spelta Valbuza, Juliana" sort="Spelta Valbuza, Juliana" uniqKey="Spelta Valbuza J" first="Juliana" last="Spelta Valbuza">Juliana Spelta Valbuza</name><name sortKey="Spelta Valbuza, Juliana" sort="Spelta Valbuza, Juliana" uniqKey="Spelta Valbuza J" first="Juliana" last="Spelta Valbuza">Juliana Spelta Valbuza</name><name sortKey="Spelta Valbuza, Juliana" sort="Spelta Valbuza, Juliana" uniqKey="Spelta Valbuza J" first="Juliana" last="Spelta Valbuza">Juliana Spelta Valbuza</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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