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 : 004285 ( Main/Merge ); précédent : 004284; suivant : 004286A 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 [France] ; D. J. Brooks [Royaume-Uni] ; A. D. Korczyn [Israël] ; P. P. De Deyn [Belgique] ; C. E. Clarke [Royaume-Uni] ; A. E. Lang [Canada]Source :
- The New England journal of medicine [ 0028-4793 ] ; 2000.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
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.
Links toward previous steps (curation, corpus...)
- to stream PascalFrancis, to step Corpus: 001376
- to stream PascalFrancis, to step Curation: 000062
- to stream PascalFrancis, to step Checkpoint: 001248
Links to Exploration step
Pascal:00-0286455Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa</title>
<author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O." last="Rascol">O. Rascol</name>
<affiliation wicri:level="3"><inist: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>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Occitanie (région administrative)</region>
<region type="old region">Midi-Pyrénées</region>
<settlement type="city">Toulouse</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Brooks, D J" sort="Brooks, D J" uniqKey="Brooks D" first="D. J." last="Brooks">D. J. Brooks</name>
<affiliation wicri:level="3"><inist: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>
</inist:fA14>
<country>Royaume-Uni</country>
<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, A D" sort="Korczyn, A D" uniqKey="Korczyn A" first="A. D." last="Korczyn">A. D. Korczyn</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Tel Aviv University Medical School</s1>
<s2>Ramat Aviv</s2>
<s3>ISR</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>Israël</country>
<wicri:noRegion>Ramat Aviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="De Deyn, P P" sort="De Deyn, P P" uniqKey="De Deyn P" first="P. P." last="De Deyn">P. P. De Deyn</name>
<affiliation wicri:level="4"><inist: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>
</inist:fA14>
<country>Belgique</country>
<placeName><settlement type="city">Anvers</settlement>
<region>Région flamande</region>
<region type="district" nuts="2">Province d'Anvers</region>
</placeName>
<orgName type="university">Université d'Anvers</orgName>
</affiliation>
</author>
<author><name sortKey="Clarke, C E" sort="Clarke, C E" uniqKey="Clarke C" first="C. E." last="Clarke">C. E. Clarke</name>
<affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Department of Neurology, University of Birmingham</s1>
<s2>Birmingham</s2>
<s3>GBR</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Birmingham</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Midlands de l'Ouest</region>
</placeName>
<orgName type="university">Université de Birmingham</orgName>
</affiliation>
</author>
<author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name>
<affiliation wicri:level="1"><inist: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>
</inist:fA14>
<country>Canada</country>
<wicri:noRegion>Toronto</wicri:noRegion>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">00-0286455</idno>
<date when="2000">2000</date>
<idno type="stanalyst">PASCAL 00-0286455 INIST</idno>
<idno type="RBID">Pascal:00-0286455</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">001376</idno>
<idno type="wicri:Area/PascalFrancis/Curation">000062</idno>
<idno type="wicri:Area/PascalFrancis/Checkpoint">001248</idno>
<idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">001248</idno>
<idno type="wicri:doubleKey">0028-4793:2000:Rascol O:a:five:year</idno>
<idno type="wicri:Area/Main/Merge">004285</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa</title>
<author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O." last="Rascol">O. Rascol</name>
<affiliation wicri:level="3"><inist: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>
</inist:fA14>
<country>France</country>
<placeName><region type="region">Occitanie (région administrative)</region>
<region type="old region">Midi-Pyrénées</region>
<settlement type="city">Toulouse</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Brooks, D J" sort="Brooks, D J" uniqKey="Brooks D" first="D. J." last="Brooks">D. J. Brooks</name>
<affiliation wicri:level="3"><inist: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>
</inist:fA14>
<country>Royaume-Uni</country>
<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, A D" sort="Korczyn, A D" uniqKey="Korczyn A" first="A. D." last="Korczyn">A. D. Korczyn</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Tel Aviv University Medical School</s1>
<s2>Ramat Aviv</s2>
<s3>ISR</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>Israël</country>
<wicri:noRegion>Ramat Aviv</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="De Deyn, P P" sort="De Deyn, P P" uniqKey="De Deyn P" first="P. P." last="De Deyn">P. P. De Deyn</name>
<affiliation wicri:level="4"><inist: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>
</inist:fA14>
<country>Belgique</country>
<placeName><settlement type="city">Anvers</settlement>
<region>Région flamande</region>
<region type="district" nuts="2">Province d'Anvers</region>
</placeName>
<orgName type="university">Université d'Anvers</orgName>
</affiliation>
</author>
<author><name sortKey="Clarke, C E" sort="Clarke, C E" uniqKey="Clarke C" first="C. E." last="Clarke">C. E. Clarke</name>
<affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Department of Neurology, University of Birmingham</s1>
<s2>Birmingham</s2>
<s3>GBR</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName><settlement type="city">Birmingham</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Midlands de l'Ouest</region>
</placeName>
<orgName type="university">Université de Birmingham</orgName>
</affiliation>
</author>
<author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name>
<affiliation wicri:level="1"><inist: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>
</inist:fA14>
<country>Canada</country>
<wicri:noRegion>Toronto</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
<imprint><date when="2000">2000</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Agonist</term>
<term>Aminoacid</term>
<term>Antiparkinson agent</term>
<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>
<term>Ropinirole</term>
<term>Treatment</term>
<term>Treatment efficiency</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Homme</term>
<term>Précoce</term>
<term>Randomisation</term>
<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>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<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>
</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>Occitanie (région administrative)</li>
<li>Province d'Anvers</li>
<li>Région flamande</li>
</region>
<settlement><li>Anvers</li>
<li>Birmingham</li>
<li>Londres</li>
<li>Toulouse</li>
</settlement>
<orgName><li>Université d'Anvers</li>
<li>Université de Birmingham</li>
</orgName>
</list>
<tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O." last="Rascol">O. Rascol</name>
</region>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Brooks, D J" sort="Brooks, D J" uniqKey="Brooks D" first="D. J." last="Brooks">D. J. Brooks</name>
</region>
<name sortKey="Clarke, C E" sort="Clarke, C E" uniqKey="Clarke C" first="C. E." last="Clarke">C. E. Clarke</name>
</country>
<country name="Israël"><noRegion><name sortKey="Korczyn, A D" sort="Korczyn, A D" uniqKey="Korczyn A" first="A. D." last="Korczyn">A. D. Korczyn</name>
</noRegion>
</country>
<country name="Belgique"><region name="Région flamande"><name sortKey="De Deyn, P P" sort="De Deyn, P P" uniqKey="De Deyn P" first="P. P." last="De Deyn">P. P. De Deyn</name>
</region>
</country>
<country name="Canada"><noRegion><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonFranceV1/Data/Main/Merge
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004285 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Merge/biblio.hfd -nk 004285 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= ParkinsonFranceV1 |flux= Main |étape= Merge |type= RBID |clé= Pascal:00-0286455 |texte= A five-year study of the incidence of dyskinesia in patients with early parkinson's disease who were treated with ropinirole or levodopa }}
![]() | This area was generated with Dilib version V0.6.29. | ![]() |