If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  New Parkinson's Guidelines Call for Dopamine Agonists as First Line Treatment RESEARCH TRIANGLE PARK, NC -- June 12, 2001 -- Dopamine agonists are recommended as initial first-line, monotherapy in early stage Parkinson's disease, according to new treatment guidelines published as a supplement in this month's issue of the journal Neurology. The evidence-based guidelines, developed by leading neurologists, now recommend starting with a "levodopa sparing" dopamine agonist to reduce the risk of developing dyskinesias and motor fluctuations. This new emphasis on dopamine agonists in a first-line position is a key difference from the 1998 guidelines, which suggested that either a dopamine agonist or levodopa could be used as initial monotherapy for early Parkinson's disease. Requip® (ropinirole HCl) tablets, one drug in the class of dopamine agonists, is indicated for the treatment of the signs and symptoms of idiopathic Parkinson's disease. "Since the publication of the original treatment algorithm three years ago, there have been a number of prospective double blind studies, which have advanced our understanding of how to treat patients with early Parkinson's disease," said C. Warren Olanow, M.D., FRCPC, supplement editor and chairman of the department of neurology at Mt. Sinai School of Medicine. "One important update in this algorithm is the recommendation to consider initiating therapy for Parkinson's disease patients with a dopamine agonist in order to reduce the risk of developing dyskinesias and motor fluctuations." One of these significant studies outlined in the algorithm was the 5-year,double blind controlled, landmark study published in The New England Journal of Medicine in May 2000 that showed Requip (ropinirole HCl) significantly lowers patients' risk of developing dyskinesias when compared to treatment with levodopa. In this study, only 20 percent of the patients that received Requip versus 46 percent of the patients that received levodopa experienced dyskinesias. Dyskinesias are the often severe, uncontrollable, jerky body movements that commonly plague people with Parkinson's disease. A third of the patients on Requip (29) in the study continued with ropinirole therapy for their Parkinson's disease over the course of five years without the addition of levodopa. Also noted in the algorithm published in Neurology is the recommendation to add supplemental levodopa to treatment as Parkinson's disease progresses when dopamine agonist monotherapy can no longer adequately control Parkinson's disease symptoms.
Also provided in the treatment algorithm are recommendations for managing motor complications associated with levodopa therapy, suggestions for managing neuropsychiatric problems, autonomic dysfunction and sleep disorders associated with Parkinson's disease, new pharmacological approaches for treating early stage Parkinson's disease and innovative surgical procedures for treating advanced stage Parkinson's disease. "The new treatment algorithm reflects the paradigm shift that has occurred in the treatment of Parkinson's disease in the last three years," said Dr. Olanow. "The new algorithm is designed to help guide healthcare practitioners in identifying and selecting different treatment options for managing patients in the different stages of Parkinson's disease." The supplement was made possible through an educational grant from GlaxoSmithKline. Parkinson's disease, which affects between 500,000 and one million Americans, is a chronic and progressive disorder that results from the death of nerve cells in a critical area of the brain called the substantia nigra. These nerve cells normally produce dopamine, a chemical messenger that plays an important role in motor movement control by transmitting signals between different areas of the brain. Dopamine depletion results in a patient's impaired ability to control motor movements. Increasing the dosage of levodopa can cause many patients to experience levodopa-induced side effects such as dyskinesias, which can have a negative impact on a patient's ability to function. Requip (ropinirole HCl), a second-generation dopamine agonist, is generally well tolerated. The most commonly reported side effects are nausea, somnolence, dizziness, headache and dyskinesia. Patients are advised to talk to their doctor about whether they have the potential to develop the sedating effects associated with Requip, which include somnolence, and the possibility of falling asleep while engaged in activities of daily living, including operation of a motor vehicle. Fainting or low blood pressure may occur during initial treatment or with an increase in dose. Hallucinations may occur at anytime during treatment. Requip may potentiate the side effects of levodopa SOURCE: GlaxoSmithKline Related Links: GlaxoSmithKline and Requip (ropinirole HCl).
|
