Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL‐PET study

Annals of Neurology - Tập 54 Số 1 - Trang 93-101 - 2003
Alan Whone1, Ray L. Watts2, A. Jon Stoessl3, Margaret R. Davis2, Sven N. Reske4, Claude Nahmias5, Anthony E. Lang6, Olivier Rascol7, Maria João Ribeiro8, Philippe Rémy8, Werner Poewe9, Robert A. Hauser10, David J. Brooks1
1Faculty of Medicine, Imperial College, Hammersmith Hospital, London, United Kingdom
2Department of Neurology, Emory University School of Medicine, Atlanta, Ga
3University of British Columbia, Vancouver, British Columbia, Canada
4Universität Ulm, Ulm, Germany
5McMaster University, Hamilton
6Division of Neurology, Department of Medicine, University of Toronto, Ontario, Canada
7Department of Clinical Pharmacology, Clinical Investigation Centre, INSERM U455, Toulouse University Hospital, Toulouse
8CEA-CNRS URA 2210, Service Hospitalier F. Joliot, Orsay, France
9Department of Clinical Neurology, University of Innsbruck, Innsbruck, Austria
10University of South Florida and Tampa General Healthcare, Tampa, FL

Tóm tắt

AbstractPreclinical studies suggest ropinirole (a D2/D3 dopamine agonist) may be neuroprotective in Parkinson's disease (PD), and a pilot clinical study using 18F‐dopa positron emission tomography (PET) suggested a slower loss of striatal dopamine storage with ropinirole compared with levodopa. This prospective, 2‐year, randomized, double‐blind, multinational study compared the rates of loss of dopamine‐terminal function in de novo patients with clinical and 18F‐dopa PET evidence of early PD, randomized 1 to 1 to receive either ropinirole or levodopa. The primary outcome measure was reduction in putamen 18F‐dopa uptake (Ki) between baseline and 2‐year PET. Of 186, 162 randomized patients were eligible for analysis. A blinded, central, region‐of‐interest analysis showed a significantly lower reduction (p = 0.022) in putamen Ki over 2 years with ropinirole (−13.4%; n = 68) compared with levodopa (−20.3%; n = 59; 95% confidence interval [CI], 0.65–13.06). Statistical parametric mapping localized lesser reductions in 18F‐dopa uptake in the putamen and substantia nigra with ropinirole. The greatest Ki decrease in each group was in the putamen (ropinirole, −14.1%; levodopa, −22.9%; 95% CI, 4.24–13.3), but the decrease was significantly lower with ropinirole compared with levodopa (p < 0.001). Ropinirole is associated with slower progression of PD than levodopa as assessed by 18F‐dopa PET. Ann Neurol 2003

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Annals of Neurology

Tập 54 Số 1

93-101

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