title: Restless legs syndrome augmentation among Japanese patients receiving pramipexole therapy: Rate and risk factors in a retrospective study.
abstract: To investigate the rate of and risk factors for restless legs syndrome (RLS) augmentation in Japanese patients receiving pramipexole (PPX) treatment. Records of 231 consecutive patients with idiopathic RLS who received PPX therapy for more than one month in a single sleep disorder center were analyzed retrospectively. Augmentation was diagnosed based on the Max Planck Institute criteria; associated factors were identified by logistic regression analysis. Mean age at PPX initiation was 60.6 ± 14.9 years and mean treatment duration was 48.5 ± 26.4 months. Augmentation was diagnosed in 21 patients (9.1%). Daily PPX dose and treatment duration were significantly associated with augmentation. By analyzing the receiver operating characteristic curve, a PPX dose of 0.375 mg/day was found to be the optimal cut-off value for predicting augmentation. After stratifying patients according to PPX treatment duration, at median treatment duration of 46 months, optimal cut-off values for daily doses were 0.375 and 0.500 mg/day for <46 months and ≥46 months of treatment, respectively. The RLS augmentation with PPX treatment in Japanese patients was occurred at rate of 9.1%, being quite compatible with previously reported rates in Caucasian patients. The symptom could appear within a relatively short period after starting the treatment in possibly vulnerable cases even with a smaller drug dose. Our results support the importance of keeping doses of PPX low throughout the RLS treatment course to prevent augmentation.
authors.affiliation: Department of Somnology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.|Maezawa Hospital, Tochigi, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Nishida
authors.affiliation: Department of Somnology, Tokyo Medical University, Tokyo, Japan.|Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
authors.forename: Mina
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.|Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsui
authors.affiliation: Department of Somnology, Tokyo Medical University, Tokyo, Japan.|Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
authors.forename: Eiki
authors.initials: E
authors.lastname: Ito
authors.affiliation: Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Usui
authors.affiliation: Department of Somnology, Tokyo Medical University, Tokyo, Japan.|Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000368:Aged; D052160:Benzothiazoles / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018450:Disease Progression; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077487:Pramipexole; D012372:ROC Curve; D012148:Restless Legs Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D052160:Benzothiazoles; D018491:Dopamine Agonists; D000077487:Pramipexole