Dopamine agonists: what is the place of the newer compounds in the treatment of Parkinson's disease?
Identifieur interne : 001435 ( PubMed/Corpus ); précédent : 001434; suivant : 001436Dopamine agonists: what is the place of the newer compounds in the treatment of Parkinson's disease?
Auteurs : O. RascolSource :
- Journal of neural transmission. Supplementum [ 0303-6995 ] ; 1999.
English descriptors
- KwdEn :
- MESH :
- chemical , agonists : Receptors, Dopamine D2.
- chemical , therapeutic use : Dopamine Agonists.
- drug therapy : Parkinson Disease.
- Evidence-Based Medicine, Humans, Treatment Outcome.
Abstract
Three new dopamine agonists (cabergoline, pramipexole, ropinirole) have been put on to the market within the past months to treat patients with Parkinson's disease. Like any marketed dopamine agonists, the new compounds bind to the D2-like receptors. Pramipexole and ropinirole appear to be quite close drugs. Both are selective non ergot D2 (and preferentially D3) agonists, with an elimination half-life of 5 to 10 hours. Conversely, cabergoline is an ergot derivative, less selective for the D2 receptors, with a much longer elimination half-life (60 hours or more). In moderately advanced levodopa treated patients with Parkinson's disease and motor fluctuations, cabergoline, pramipexole and ropinirole all do significantly better than placebo in reducing UPDRS motor examination scores, time spent off and daily dose of levodopa. None of the 3 newer agonists proved to do significantly better than bromocriptine in this indication, at the cost of very similar adverse effects. In de novo levodopa naive patients, pramipexole and ropinirole did significantly better than placebo in short-term (few months) follow-up trials, at the cost again of classical dopaminergic adverse effects. Ropinirole was marginally more effective than bromocriptine, while its use induced the same risk of psychosis than the "old" reference agonist. Early treatment with cabergoline, compared with levodopa, in a long-term (5 year) study reduced the relative risk of developping motor complication by more than 50%. A similar study is presently on-going to compare ropinirole and levodopa. Clinical trials to assess putative neuroprotective effects are also on going with ropinirole and pramipexole. Up to now, the available clinical controlled data suggest that the newer dopamine agonists have very similar clinical effects with only minor superiority, if any, versus bromocriptine.
PubMed: 10335491
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Rascol</name><affiliation><nlm:affiliation>Department of Clinical Pharmacology, INSERM U455, University Hospital, Toulouse, France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1999">1999</date><idno type="RBID">pubmed:10335491</idno><idno type="pmid">10335491</idno><idno type="wicri:Area/PubMed/Corpus">001435</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001435</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Dopamine agonists: what is the place of the newer compounds in the treatment of Parkinson's disease?</title><author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name><affiliation><nlm:affiliation>Department of Clinical Pharmacology, INSERM U455, University Hospital, Toulouse, France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Journal of neural transmission. Supplementum</title><idno type="ISSN">0303-6995</idno><imprint><date when="1999" type="published">1999</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Dopamine Agonists (therapeutic use)</term><term>Evidence-Based Medicine</term><term>Humans</term><term>Parkinson Disease (drug therapy)</term><term>Receptors, Dopamine D2 (agonists)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="agonists" xml:lang="en"><term>Receptors, Dopamine D2</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Evidence-Based Medicine</term><term>Humans</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Three new dopamine agonists (cabergoline, pramipexole, ropinirole) have been put on to the market within the past months to treat patients with Parkinson's disease. Like any marketed dopamine agonists, the new compounds bind to the D2-like receptors. Pramipexole and ropinirole appear to be quite close drugs. Both are selective non ergot D2 (and preferentially D3) agonists, with an elimination half-life of 5 to 10 hours. Conversely, cabergoline is an ergot derivative, less selective for the D2 receptors, with a much longer elimination half-life (60 hours or more). In moderately advanced levodopa treated patients with Parkinson's disease and motor fluctuations, cabergoline, pramipexole and ropinirole all do significantly better than placebo in reducing UPDRS motor examination scores, time spent off and daily dose of levodopa. None of the 3 newer agonists proved to do significantly better than bromocriptine in this indication, at the cost of very similar adverse effects. In de novo levodopa naive patients, pramipexole and ropinirole did significantly better than placebo in short-term (few months) follow-up trials, at the cost again of classical dopaminergic adverse effects. Ropinirole was marginally more effective than bromocriptine, while its use induced the same risk of psychosis than the "old" reference agonist. Early treatment with cabergoline, compared with levodopa, in a long-term (5 year) study reduced the relative risk of developping motor complication by more than 50%. A similar study is presently on-going to compare ropinirole and levodopa. Clinical trials to assess putative neuroprotective effects are also on going with ropinirole and pramipexole. Up to now, the available clinical controlled data suggest that the newer dopamine agonists have very similar clinical effects with only minor superiority, if any, versus bromocriptine.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">10335491</PMID><DateCreated><Year>1999</Year><Month>08</Month><Day>03</Day></DateCreated><DateCompleted><Year>1999</Year><Month>08</Month><Day>03</Day></DateCompleted><DateRevised><Year>2005</Year><Month>11</Month><Day>16</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0303-6995</ISSN><JournalIssue CitedMedium="Print"><Volume>55</Volume><PubDate><Year>1999</Year></PubDate></JournalIssue><Title>Journal of neural transmission. Supplementum</Title><ISOAbbreviation>J. Neural Transm. Suppl.</ISOAbbreviation></Journal><ArticleTitle>Dopamine agonists: what is the place of the newer compounds in the treatment of Parkinson's disease?</ArticleTitle><Pagination><MedlinePgn>33-45</MedlinePgn></Pagination><Abstract><AbstractText>Three new dopamine agonists (cabergoline, pramipexole, ropinirole) have been put on to the market within the past months to treat patients with Parkinson's disease. Like any marketed dopamine agonists, the new compounds bind to the D2-like receptors. Pramipexole and ropinirole appear to be quite close drugs. Both are selective non ergot D2 (and preferentially D3) agonists, with an elimination half-life of 5 to 10 hours. Conversely, cabergoline is an ergot derivative, less selective for the D2 receptors, with a much longer elimination half-life (60 hours or more). In moderately advanced levodopa treated patients with Parkinson's disease and motor fluctuations, cabergoline, pramipexole and ropinirole all do significantly better than placebo in reducing UPDRS motor examination scores, time spent off and daily dose of levodopa. None of the 3 newer agonists proved to do significantly better than bromocriptine in this indication, at the cost of very similar adverse effects. In de novo levodopa naive patients, pramipexole and ropinirole did significantly better than placebo in short-term (few months) follow-up trials, at the cost again of classical dopaminergic adverse effects. Ropinirole was marginally more effective than bromocriptine, while its use induced the same risk of psychosis than the "old" reference agonist. Early treatment with cabergoline, compared with levodopa, in a long-term (5 year) study reduced the relative risk of developping motor complication by more than 50%. A similar study is presently on-going to compare ropinirole and levodopa. Clinical trials to assess putative neuroprotective effects are also on going with ropinirole and pramipexole. Up to now, the available clinical controlled data suggest that the newer dopamine agonists have very similar clinical effects with only minor superiority, if any, versus bromocriptine.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rascol</LastName><ForeName>O</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Department of Clinical Pharmacology, INSERM U455, University Hospital, Toulouse, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Austria</Country><MedlineTA>J Neural Transm Suppl</MedlineTA><NlmUniqueID>0425126</NlmUniqueID><ISSNLinking>0303-6995</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018491">Dopamine Agonists</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D017448">Receptors, Dopamine D2</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D018491" MajorTopicYN="N">Dopamine Agonists</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019317" MajorTopicYN="N">Evidence-Based Medicine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017448" MajorTopicYN="N">Receptors, Dopamine D2</DescriptorName><QualifierName UI="Q000819" MajorTopicYN="N">agonists</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><NumberOfReferences>66</NumberOfReferences></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1999</Year><Month>5</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1999</Year><Month>5</Month><Day>21</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1999</Year><Month>5</Month><Day>21</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">10335491</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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