Evaluation of the efficacy of pramipexole for treating levodopa-induced dyskinesia in patients with Parkinson's disease.
OBJECTIVE
The long-term use of levodopa to treat Parkinson's disease (PD) is often limited by the development of motor complications (e.g., levodopa-induced dyskinesia, LID). We hypothesized that a non-ergot dopamine agonist with strong affinity for D3) dopamine receptors (pramipexole) may improve LID in patients taking an ergot D1/D2 dopamine agonist.


METHODS
Patients with PD and LID being treated with levodopa in addition to an ergot dopamine agonist were randomized to either a group in which pramipexole was added to current medications or a group in which the ergot dopamine agonist was switched to pramipexole. Dyskinesia was evaluated using Core Assessment Program for Surgical Interventional Therapies scores. The unified Parkinson's disease rating scale scores, modified Hoehn and Yahr stages (at 'on' time), Parkinson's disease questionnaire-39 scores and clinical global impression-improvement scores were also used for evaluation.


RESULTS
At 24 weeks, pramipexole alleviated LID with more efficiency in the switch group.


CONCLUSIONS
Pramipexole may be a therapeutic option for treating LID because its effects on D3 dopamine receptors may balance the D1 dopamine receptor supersensitivity associated with LID.
Department of Neurology, Tokyo Medical University, Japan.
Hiroya
H
Utsumi
Yasuyuki
Y
Okuma
Osamu
O
Kano
Yutaka
Y
Suzuki
Mutsumi
M
Iijima
Hiroyuki
H
Tomimitsu
Hideji
H
Hashida
Shin-Ichiro
S
Kubo
Masahiko
M
Suzuki
Kazunori
K
Nanri
Miyuki
M
Matsumura
Hidetomo
H
Murakami
Nobutaka
N
Hattori
D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects*; D052160:Benzothiazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D001971:Bromocriptine / Q000008:administration & dosage; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy* / Q000503:physiopathology; D004873:Ergolines / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D010479:Pergolide / Q000008:administration & dosage; D000077487:Pramipexole; D017447:Receptors, Dopamine D1 / Q000819:agonists; D017448:Receptors, Dopamine D2 / Q000819:agonists; D050637:Receptors, Dopamine D3 / Q000819:agonists
D000978:Antiparkinson Agents; D052160:Benzothiazoles; C581293:DRD2 protein, human; D018491:Dopamine Agonists; D004873:Ergolines; D017447:Receptors, Dopamine D1; D017448:Receptors, Dopamine D2; D050637:Receptors, Dopamine D3; D010479:Pergolide; D001971:Bromocriptine; D007980:Levodopa; D000077487:Pramipexole; D000077465:Cabergoline