A multicenter trial of ropinirole as adjunct treatment for Parkinson's disease. Ropinirole Study Group.
OBJECTIVE
To evaluate the nonergot dopamine agonist ropinirole as an adjunct to L-dopa in a randomized, double-blind trial in PD patients with motor fluctuations.


BACKGROUND
L-dopa in the treatment of PD is associated with motor fluctuations, dyskinesia, and other adverse effects. The use of dopamine agonists in the treatment of PD delays recourse to L-dopa and thus delays the possibility of adverse effect onset.


METHODS
Ropinirole (n = 95) or placebo (n = 54) was added to L-dopa, and L-dopa was then reduced in a planned manner during the 6-month trial.


RESULTS
A significantly greater number of ropinirole patients were able to achieve a 20% or greater reduction in both L-dopa dose and in percent time spent "off" compared with placebo (35.0% versus 13.0%; p = 0.003). The mean daily L-dopa dose was reduced significantly with ropinirole treatment (242 mg versus 51 mg; p < 0.001) as was the percent awake time spent "off" (11.7% versus 5.1%; p = 0.039). There was no difference in the percent of patients who withdrew because of adverse effects (15.8% on ropinirole versus 16.7% on placebo).


CONCLUSIONS
Ropinirole permits a reduction in L-dopa dose with enhanced clinical benefit for PD patients with motor fluctuations.
Lieberman
A
A
Barrow Neurological Institute, Phoenix, AZ 85013-4496, USA.
Olanow
C W
CW
Sethi
K
K
Swanson
P
P
Waters
C H
CH
Fahn
S
S
Hurtig
H
H
Yahr
M
M
D000978:Antiparkinson Agents / Q000008:administration & dosage*; D018491:Dopamine Agonists / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage*; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy*; D011446:Prospective Studies
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007211:Indoles; C046649:ropinirole; D007980:Levodopa