A multicentre retrospective study of the clinical use of ropinirole in the treatment of Parkinson's disease: The ROPI-PARK Study

Causes and factors related to dopamine agonist withdrawal in Parkinson′s disease

“…Moreover, adverse events in three other cases were in the context of cognitive impairment progressing to dementia. Previous observational studies have largely focused on discontinuation rates for DAs introduced as a supplement to levodopa (Hauser et al 2007;Arbouw et al 2008Arbouw et al , 2009Parkinson Study Group 2009;Valldeoriola et al 2009;Nissen et al 2012). A maintenance of pramipexole in approximately 80% at 6 years (Parkinson Study Group 2009) and 90% between 5 and 10 years for ropinirole (Hauser et al 2007) has been reported in extended open-label observational studies.…”

Duration of l-dopa and dopamine agonist monotherapy in Parkinson's disease

“…1 Previous observational studies have largely focused on discontinuation rates for dopamine agonists introduced as a supplement to l -dopa, rather than requirements after starting monotherapy. 7,8,11,13 We acknowledge that our study addresses only one component of the treatment decision pathway, which varies across different centres, and that we did not capture data relating for example to the initial use of rasagiline or alternative treatments. While some data on the duration of monotherapy is available from clinical trials, nearly all such studies allowed open-label l -dopa as a supplement, or monoamine oxidase B inhibitors or amantadine as concomitant medication, 3,14–16 and none one of the studies reported survival analysis.…”

“…6 Such studies of routine clinical practice are generally smaller than recent clinical trials and include cases at all disease stages, so the number of patients taking monotherapy is typically fewer than 100. 711 We report here the observations in a large clinical series of early stage PD patients. Our aims were to define the duration of l -dopa monotherapy compared with dopamine agonists before adjunctive treatment in a naturalistic clinic setting and to define adverse events and associated discontinuation rates, and contrast the findings with those in clinical trials.…”

Prevalencia de las complicaciones del tratamiento antiparkinsoniano: revisión sistemática y estimación de proyecciones

“…De estos, 24 cumplieron los requisitos de inclusión (ver figura 1). Entre estos 24 artículos se encuentran 5 meta-análisis[12][13][14][15][16]; 10 estudios multicéntricos[17][18][19][20][21] de los cuales 5 son ensayos clínicos aleatorizados[27][28][29][30][31]; 3 ensayos clínicos en uno solo centro[32][33][34] y; 6 estudios observacionales[35][36][37][38][39][40].Los resultados de este estudio presentan datos sobre los siguientes efectos adversos en relación con los tratamientos antiparkinsonianos: artralgia, reacción en el lugar de aplicación, caídas, diarrea, edema, dolor de cabeza, estreñimiento, fatiga o cansancio, insomnio, mareos, discinesias o aumento de discinesias, dolor (general o de espalda), fallo cardíaco, nauseas, hipotensión o hipotensión ortostática, psicosis o alucinaciones, somnolencia o sedación, trastornos del control de impulsos, valvulopatía o regurgitación valvular, y vómitos (ver tabla II). 92%) se presentaron con todos los fármacos antiparkinsonianos (2%-44,4%).Entre los efectos adversos relacionados con síntomas neuropsiquiátricos aparecen psicosis o alucinaciones (0,6-16,1%) y trastornos del control de impulsos (o ICD) (5,8-43,1%).…”