罗匹尼罗:回顾其在帕金森病的管理使用。

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马西森AJ,斯宾塞CM

罗匹尼罗:回顾其在帕金森病的管理使用。

药。2000年7月,60 (1):115 - 37。doi: 10.2165 / 00003495-200060010-00007。

PubMed ID

10929932 (在PubMed

]

文摘

未标记的:罗匹尼罗、non-ergoline多巴胺受体激动剂,对多巴胺D2-like受体选择性亲和力,很少或根本没有non-dopaminergic大脑受体的亲和力。罗匹尼罗表示作为辅助治疗在晚期帕金森症患者左旋多巴。还表示,最近的临床试验的关注它的使用,作为单药治疗的患者早期帕金森病。罗匹尼罗在早期帕金森病的症状治疗单一疗法明显比安慰剂更有效在2多中心、随机、双盲试验3到12个月的时间评估的统一帕金森病评定量表(UPDRS)运动成绩和临床印象/临床全球评估尺度。与溴麦角环肽类似设计三年比较研究,罗匹尼罗收件人显示显著改善UPDRS,日常生活活动(ADL)分数;然而,两组之间的运动成绩都相似。罗匹尼罗和左旋多巴治疗相似功效的UPDRS ADL评分,尽管罗匹尼罗收件人显示显著减少改善UPDRS运动成绩在5年的研究终点多中心、随机双盲试验。作为辅助治疗左旋多巴在更高级的帕金森症患者,据报道,罗匹尼罗溴麦角环肽一样有效,比安慰剂更有效。一般在与安慰剂比较罗匹尼罗允许> = 20%减少随之而来的剂量左旋多巴的疗效的前提下在很大比例的患者,在一些试验中减少的清醒时间在“关闭”状态(“关闭”状态被定义为逐步回归震颤麻痹尽管适当的药物)。罗匹尼罗很容忍作为单一疗法或左旋多巴治疗的一个附属物。 Nausea, dizziness and somnolence were the most commonly reported adverse events and were reported at a higher incidence by patients receiving ropinirole than by those receiving placebo. In patients with early Parkinson's disease, ropinirole generally showed a similar overall tolerability profile to bromocriptine although, over a 3-year period nausea was more commonly reported with ropinirole recipients. In a 5-year study, the incidence of dyskinesia was significantly lower with ropinirole than with levodopa regardless of levodopa supplementation. Prior to the addition of supplementary levodopa 5% of ropinirole recipients had experienced dyskinesia compared with 36% of those receiving levodopa. CONCLUSIONS: In patients with early Parkinson's disease, ropinirole monotherapy was more efficacious than bromocriptine with regard to improvement in activities of daily living, and need for supplemental levodopa. Ropinirole recipients had a higher requirement for levodopa supplementation than levodopa recipients in a 5-year study, but the incidence of dyskinesia was significantly lower with ropinirole than with levodopa (markedly so in the one third of ropinirole recipients who were able to remain on monotherapy with no levodopa supplementation). Thus available data suggest that ropinirole may provide a means of treating early Parkinson's disease while minimising the risk of dyskinesia and delaying the need for supplemental levodopa in some patients. In addition, ropinirole is also efficacious in the management of more advanced Parkinson's disease in patients who are experiencing motor complications after long term levodopa use.

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罗匹尼罗