title: Onset of dyskinesia with adjunct ropinirole prolonged-release or additional levodopa in early Parkinson's disease.
abstract: Levodopa-induced dyskinesia can result in significant functional disability and reduced quality of life in patients with Parkinson's disease (PD). The goal of this study was to determine if the addition of once-daily ropinirole 24-hour prolonged-release (n = 104) in PD patients not optimally controlled with levodopa after up to 3 years of therapy with less than 600 mg/d delays the onset of dyskinesia compared with increasing doses of levodopa (n = 104). During the study, 3% of the ropinirole prolonged-release group (mean dose 10 mg/d) and 17% of the levodopa group (mean additional dose 284 mg/d) developed dyskinesia (P < 0.001). There were no significant differences in change in Unified Parkinson's Disease Rating Scale activities of daily living or motor scores, suggesting comparable efficacy between the two treatments. Adverse events were comparable in the two groups with nausea, dizziness, insomnia, back pain, arthralgia, somnolence, fatigue, and pain most commonly reported. Ropinirole prolonged-release delayed the onset of dyskinesia with comparable efficacy to increased doses of levodopa in early PD patients not optimally controlled with levodopa.
authors.affiliation: Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0017, USA. rlwatts@uab.edu
authors.forename: Ray L
authors.initials: RL
authors.lastname: Watts
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Lyons
authors.forename: Rajesh
authors.initials: R
authors.lastname: Pahwa
authors.forename: Kapil
authors.initials: K
authors.lastname: Sethi
authors.forename: Matthew
authors.initials: M
authors.lastname: Stern
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hauser
authors.forename: Warren
authors.initials: W
authors.lastname: Olanow
authors.forename: Alex M
authors.initials: AM
authors.lastname: Gray
authors.forename: Bryan
authors.initials: B
authors.lastname: Adams
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Earl
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects*; D003692:Delayed-Action Preparations / Q000009:adverse effects; D004185:Disability Evaluation; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000978:Antiparkinson Agents; D003692:Delayed-Action Preparations; D007211:Indoles; C046649:ropinirole; D007980:Levodopa