Development of dyskinesias in a 5-year trial of ropinirole and L-dopa.
Identifieur interne : 002B20 ( PubMed/Corpus ); précédent : 002B19; suivant : 002B21Development 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 : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2006.
English descriptors
- KwdEn :
- Antiparkinson Agents (adverse effects), Confidence Intervals, Drug Therapy, Combination, Dyskinesia, Drug-Induced (etiology), Dyskinesia, Drug-Induced (mortality), Humans, Indoles (adverse effects), Levodopa (adverse effects), Longitudinal Studies, Parkinson Disease (drug therapy), Parkinson Disease (epidemiology), Parkinson Disease (mortality), Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Survival Analysis.
- 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.
DOI: 10.1002/mds.20988
PubMed: 16958094
Links to Exploration step
pubmed:16958094Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Development of dyskinesias in a 5-year trial of ropinirole and L-dopa.</title><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation><nlm:affiliation>Clinical Investigation Centre, Department of Pharmacology and INSERM U455, Toulouse Hospital, Toulouse, France. rascol@cict.fr</nlm:affiliation></affiliation></author><author><name sortKey="Brooks, David J" sort="Brooks, David J" uniqKey="Brooks D" first="David J" last="Brooks">David J. Brooks</name></author><author><name sortKey="Korczyn, Amos D" sort="Korczyn, Amos D" uniqKey="Korczyn A" first="Amos D" last="Korczyn">Amos D. Korczyn</name></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></author><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. Lang</name></author><author><name sortKey="Abdalla, Mona" sort="Abdalla, Mona" uniqKey="Abdalla M" first="Mona" last="Abdalla">Mona Abdalla</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="doi">10.1002/mds.20988</idno><idno type="RBID">pubmed:16958094</idno><idno type="pmid">16958094</idno><idno type="wicri:Area/PubMed/Corpus">002B20</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Development of dyskinesias in a 5-year trial of ropinirole and L-dopa.</title><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation><nlm:affiliation>Clinical Investigation Centre, Department of Pharmacology and INSERM U455, Toulouse Hospital, Toulouse, France. rascol@cict.fr</nlm:affiliation></affiliation></author><author><name sortKey="Brooks, David J" sort="Brooks, David J" uniqKey="Brooks D" first="David J" last="Brooks">David J. Brooks</name></author><author><name sortKey="Korczyn, Amos D" sort="Korczyn, Amos D" uniqKey="Korczyn A" first="Amos D" last="Korczyn">Amos D. Korczyn</name></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></author><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. Lang</name></author><author><name sortKey="Abdalla, Mona" sort="Abdalla, Mona" uniqKey="Abdalla M" first="Mona" last="Abdalla">Mona Abdalla</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></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, Drug-Induced (etiology)</term><term>Dyskinesia, Drug-Induced (mortality)</term><term>Humans</term><term>Indoles (adverse effects)</term><term>Levodopa (adverse effects)</term><term>Longitudinal Studies</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (epidemiology)</term><term>Parkinson Disease (mortality)</term><term>Predictive Value of Tests</term><term>Proportional Hazards Models</term><term>Risk Factors</term><term>Survival Analysis</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></textClass></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.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">16958094</PMID><DateCreated><Year>2006</Year><Month>12</Month><Day>05</Day></DateCreated><DateCompleted><Year>2007</Year><Month>02</Month><Day>20</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>21</Volume><Issue>11</Issue><PubDate><Year>2006</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Development of dyskinesias in a 5-year trial of ropinirole and L-dopa.</ArticleTitle><Pagination><MedlinePgn>1844-50</MedlinePgn></Pagination><Abstract><AbstractText>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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rascol</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Clinical Investigation Centre, Department of Pharmacology and INSERM U455, Toulouse Hospital, Toulouse, France. rascol@cict.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brooks</LastName><ForeName>David J</ForeName><Initials>DJ</Initials></Author><Author ValidYN="Y"><LastName>Korczyn</LastName><ForeName>Amos D</ForeName><Initials>AD</Initials></Author><Author ValidYN="Y"><LastName>De Deyn</LastName><ForeName>Peter P</ForeName><Initials>PP</Initials></Author><Author ValidYN="Y"><LastName>Clarke</LastName><ForeName>Carl E</ForeName><Initials>CE</Initials></Author><Author ValidYN="Y"><LastName>Lang</LastName><ForeName>Anthony E</ForeName><Initials>AE</Initials></Author><Author ValidYN="Y"><LastName>Abdalla</LastName><ForeName>Mona</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><CollectiveName>056 Study Group</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson 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