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Angelo Antonini - One of the best experts on this subject based on the ideXlab platform.
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tolerability of non ergot oral and transdermal Dopamine Agonists in younger and older parkinson s disease patients an european multicentre survey
Journal of Neural Transmission, 2020Co-Authors: A. Rizos, B. Kessel, Angelo Antonini, A. Sauerbier, P. Odin, T. Henriksen, M. Silverdale, C Faluppecurariu, Pablo Martinezmartin, G. DurnerAbstract:In older patients with Parkinson’s disease (PD), the use of Dopamine Agonists (DA) has been limited due to uncertainties related to their tolerability in spite of potential gains with the advent of longer acting or transdermal therapies. Comparative real-life data addressing the tolerability of DA therapy across age ranges are currently sparse. This study addressed the tolerability (Shulman criteria, continued intake of DA therapy for at least 6 months) in PD patients across several European centres treated with long-acting and transdermal DA (Rotigotine skin patch, Ropinirole extended release, or Pramipexole prolonged release) as part of routine clinical care in younger and older PD patients. A medical record-based retrospective data capture and clinical interview-based follow-up survey of patients initiating or initiated on DA treatment (short and long acting) in a real-life setting. 425 cases were included [mean age 68.3 years (range 37–90), mean duration of disease 7.5 years (range 0–37), 31.5% older age (≥ 75 years of age)]. Tolerability was above 90% irrespective of age, with no significant differences between younger and older patients. Based on our findings, we suggest that long-acting/transdermal DA are tolerated in non-demented older patients, as well as in younger patients, however, with lower daily dose in older patients.
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regression of cardiac valvulopathy related to ergot derived Dopamine Agonists
Cardiovascular Therapeutics, 2011Co-Authors: Renzo Zanettini, Angelo Antonini, Gemma Gatto, Rosa Gentile, Silvana Tesei, Gianni PezzoliAbstract:SUMMARY Aims: In a previous echocardiographic prevalence study we reported a significant increase in the frequency of heart valve regurgitation in patients with Parkinson's disease taking the ergot-derived Dopamine Agonists pergolide and cabergoline versus controls. We followed-up our original cohort of patients to ascertain whether valvulopathy regressed after discontinuation of treatment and/or its incidence increased over time. Methods: Prospective follow-up of 101 patients treated with ergot-derived Dopamine Agonists included in the prevalence study: 53 given pergolide and 48 cabergoline (64% male; 66.4 ± 8.7 years of age, 11.5 ± 5.9 years of disease, 21.8 ± 5.9 months of follow-up); 55 stopped treatment while 46 continued. The main outcomes measures, were: echocardiographic quantification of regurgitant valve disease, abnormal leaflet, or cusp thickening and measurement of mitral valve tenting area. Results: Valve abnormalities regressed in about one third of patients with significant multivalvular and in about half of the patients with monovalvular regurgitation who withdrew; no progression was observed in remaining patients. Patients continuing ergot-derived Dopamine Agonists showed progression of cardiac valvulopathy: seven new cases with three to four regurgitation grade of any valve occurred during follow-up; this regarded also patients who had been on pergolide for many years. Conclusion: Owing to the persistence of risk of heart valve damage over time and the lack of its mid-term reversibility in many patients, we believe that pergolide and cabergoline should be prescribed only when therapeutic alternatives with a better risk/benefit ratio are unavailable and the patient has access to echocardiography.
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a reassessment of risks and benefits of Dopamine Agonists in parkinson s disease
Lancet Neurology, 2009Co-Authors: Angelo Antonini, Eduardo Tolosa, Yoshikuni Mizuno, Mitsutoshi Yamamoto, Werner PoeweAbstract:Summary Neurologists have several choices of drugs that have been shown to be effective for the treatment of the symptoms of Parkinson's disease. Among the first options are the Dopamine Agonists, which are commonly used both as an early monotherapy and as an adjunct therapy to levodopa. However, before starting any treatment, the overall benefit-to-risk ratio to individual patients must be considered. For the Dopamine Agonists, the available evidence on their symptomatic efficacy, effect on long-term levodopa-related motor complications, putative effect on progression of disease, and adverse event profile must be taken into account. Recently, the ocurrence of adverse events such as leg oedema, daytime somnolence, impulse control disorders, and fibrosis have increasingly been recognised. The risks of these potentially serious adverse events must therefore be taken into account and treatment decisions should be based on considerations of risks versus benefits for individual patients.
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valvular heart disease and the use of Dopamine Agonists for parkinson s disease
The New England Journal of Medicine, 2007Co-Authors: Renzo Zanettini, Angelo Antonini, Gemma Gatto, Rosa Gentile, Silvana Tesei, Gianni PezzoliAbstract:Background Ergot-derived Dopamine receptor Agonists, often used in the treatment of Parkinson's disease, have been associated with an increased risk of valvular heart disease. Methods We performed an echocardiographic prevalence study in 155 patients taking Dopamine Agonists for Parkinson's disease (pergolide, 64 patients; cabergoline, 49; and non–ergot-derived Dopamine Agonists, 42) and 90 control subjects. Valve regurgitation was assessed according to American Society of Echocardiography recommendations. The mitral-valve tenting area was also measured and used as a quantitative index for leaflet stiffening and apical displacement of leaflet coaptation. Results Clinically important regurgitation (moderate to severe, grade 3 to 4) in any valve was found with significantly greater frequency in patients taking pergolide (23.4%) or cabergoline (28.6%) but not in patients taking non–ergot-derived Dopamine Agonists (0%), as compared with control subjects (5.6%). The relative risk for moderate or severe valve r...
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valvular heart disease and the use of Dopamine Agonists for parkinson s disease
The New England Journal of Medicine, 2007Co-Authors: Renzo Zanettini, Angelo Antonini, Gemma Gatto, Rosa Gentile, Silvana Tesei, Gianni PezzoliAbstract:BACKGROUND Ergot-derived Dopamine receptor Agonists, often used in the treatment of Parkinson's disease, have been associated with an increased risk of valvular heart disease. METHODS We performed an echocardiographic prevalence study in 155 patients taking Dopamine Agonists for Parkinson's disease (pergolide, 64 patients; cabergoline, 49; and non-ergot-derived Dopamine Agonists, 42) and 90 control subjects. Valve regurgitation was assessed according to American Society of Echocardiography recommendations. The mitral-valve tenting area was also measured and used as a quantitative index for leaflet stiffening and apical displacement of leaflet coaptation. RESULTS Clinically important regurgitation (moderate to severe, grade 3 to 4) in any valve was found with significantly greater frequency in patients taking pergolide (23.4%) or cabergoline (28.6%) but not in patients taking non-ergot-derived Dopamine Agonists (0%), as compared with control subjects (5.6%). The relative risk for moderate or severe valve regurgitation in the pergolide group was 6.3 for mitral regurgitation (P=0.008), 4.2 for aortic regurgitation (P=0.01), and 5.6 for tricuspid regurgitation (P=0.16); corresponding relative risks in the cabergoline group were 4.6 (P=0.09), 7.3 (P<0.001), and 5.5 (P=0.12). The mean mitral tenting area was significantly greater in ergot-treated patients and showed a linear relationship with the severity of mitral regurgitation. Patients treated with ergot derivatives who had grade 3 to 4 regurgitation of any valve had received a significantly higher mean cumulative dose of pergolide or cabergoline than had patients with lower grades. CONCLUSIONS The frequency of clinically important valve regurgitation was significantly increased in patients taking pergolide or cabergoline, but not in patients taking non-ergot-derived Dopamine Agonists, as compared with control subjects. These findings should be considered in evaluating the risk-benefit ratio of treatment with ergot derivatives.
Gianni Pezzoli - One of the best experts on this subject based on the ideXlab platform.
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regression of cardiac valvulopathy related to ergot derived Dopamine Agonists
Cardiovascular Therapeutics, 2011Co-Authors: Renzo Zanettini, Angelo Antonini, Gemma Gatto, Rosa Gentile, Silvana Tesei, Gianni PezzoliAbstract:SUMMARY Aims: In a previous echocardiographic prevalence study we reported a significant increase in the frequency of heart valve regurgitation in patients with Parkinson's disease taking the ergot-derived Dopamine Agonists pergolide and cabergoline versus controls. We followed-up our original cohort of patients to ascertain whether valvulopathy regressed after discontinuation of treatment and/or its incidence increased over time. Methods: Prospective follow-up of 101 patients treated with ergot-derived Dopamine Agonists included in the prevalence study: 53 given pergolide and 48 cabergoline (64% male; 66.4 ± 8.7 years of age, 11.5 ± 5.9 years of disease, 21.8 ± 5.9 months of follow-up); 55 stopped treatment while 46 continued. The main outcomes measures, were: echocardiographic quantification of regurgitant valve disease, abnormal leaflet, or cusp thickening and measurement of mitral valve tenting area. Results: Valve abnormalities regressed in about one third of patients with significant multivalvular and in about half of the patients with monovalvular regurgitation who withdrew; no progression was observed in remaining patients. Patients continuing ergot-derived Dopamine Agonists showed progression of cardiac valvulopathy: seven new cases with three to four regurgitation grade of any valve occurred during follow-up; this regarded also patients who had been on pergolide for many years. Conclusion: Owing to the persistence of risk of heart valve damage over time and the lack of its mid-term reversibility in many patients, we believe that pergolide and cabergoline should be prescribed only when therapeutic alternatives with a better risk/benefit ratio are unavailable and the patient has access to echocardiography.
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valvular heart disease and the use of Dopamine Agonists for parkinson s disease
The New England Journal of Medicine, 2007Co-Authors: Renzo Zanettini, Angelo Antonini, Gemma Gatto, Rosa Gentile, Silvana Tesei, Gianni PezzoliAbstract:Background Ergot-derived Dopamine receptor Agonists, often used in the treatment of Parkinson's disease, have been associated with an increased risk of valvular heart disease. Methods We performed an echocardiographic prevalence study in 155 patients taking Dopamine Agonists for Parkinson's disease (pergolide, 64 patients; cabergoline, 49; and non–ergot-derived Dopamine Agonists, 42) and 90 control subjects. Valve regurgitation was assessed according to American Society of Echocardiography recommendations. The mitral-valve tenting area was also measured and used as a quantitative index for leaflet stiffening and apical displacement of leaflet coaptation. Results Clinically important regurgitation (moderate to severe, grade 3 to 4) in any valve was found with significantly greater frequency in patients taking pergolide (23.4%) or cabergoline (28.6%) but not in patients taking non–ergot-derived Dopamine Agonists (0%), as compared with control subjects (5.6%). The relative risk for moderate or severe valve r...
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valvular heart disease and the use of Dopamine Agonists for parkinson s disease
The New England Journal of Medicine, 2007Co-Authors: Renzo Zanettini, Angelo Antonini, Gemma Gatto, Rosa Gentile, Silvana Tesei, Gianni PezzoliAbstract:BACKGROUND Ergot-derived Dopamine receptor Agonists, often used in the treatment of Parkinson's disease, have been associated with an increased risk of valvular heart disease. METHODS We performed an echocardiographic prevalence study in 155 patients taking Dopamine Agonists for Parkinson's disease (pergolide, 64 patients; cabergoline, 49; and non-ergot-derived Dopamine Agonists, 42) and 90 control subjects. Valve regurgitation was assessed according to American Society of Echocardiography recommendations. The mitral-valve tenting area was also measured and used as a quantitative index for leaflet stiffening and apical displacement of leaflet coaptation. RESULTS Clinically important regurgitation (moderate to severe, grade 3 to 4) in any valve was found with significantly greater frequency in patients taking pergolide (23.4%) or cabergoline (28.6%) but not in patients taking non-ergot-derived Dopamine Agonists (0%), as compared with control subjects (5.6%). The relative risk for moderate or severe valve regurgitation in the pergolide group was 6.3 for mitral regurgitation (P=0.008), 4.2 for aortic regurgitation (P=0.01), and 5.6 for tricuspid regurgitation (P=0.16); corresponding relative risks in the cabergoline group were 4.6 (P=0.09), 7.3 (P<0.001), and 5.5 (P=0.12). The mean mitral tenting area was significantly greater in ergot-treated patients and showed a linear relationship with the severity of mitral regurgitation. Patients treated with ergot derivatives who had grade 3 to 4 regurgitation of any valve had received a significantly higher mean cumulative dose of pergolide or cabergoline than had patients with lower grades. CONCLUSIONS The frequency of clinically important valve regurgitation was significantly increased in patients taking pergolide or cabergoline, but not in patients taking non-ergot-derived Dopamine Agonists, as compared with control subjects. These findings should be considered in evaluating the risk-benefit ratio of treatment with ergot derivatives.
Magdolna Hornyak - One of the best experts on this subject based on the ideXlab platform.
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efficacy and safety of Dopamine Agonists in restless legs syndrome
Sleep Medicine, 2012Co-Authors: Magdolna Hornyak, Claudia Trenkwalder, Ralf Kohnen, Hanna ScholzAbstract:Abstract Objective Restless legs syndrome (RLS) is a common neurological disorder causing considerable impairment to daily living. This article is an overview of a comprehensive Cochrane meta-analysis on the efficacy and safety of Dopamine Agonists (DAs), the first-line treatment of RLS. Methods CENTRAL, MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched for double-blind randomized controlled trials (RCTs) of DAs vs placebo. Results Thirty-five placebo-controlled RCTs (total number of patients=6954) were eligible. The likelihood of bias was considered to be low. The mean treatment duration of the RCTs was 10.3 (standard deviation 7.3) weeks, with treatment durations up to seven months. Overall, DAs showed a moderate improvement in the International RLS Severity Scale score (mean difference −5.7 points [95% confidence interval, CI, −6.7 to −4.7; P P P Conclusions This meta-analysis showed that DAs have moderate efficacy in the treatment of RLS. Actively controlled and long-term studies are still lacking. Large-scale comparative studies are needed to identify the most efficient treatments for this chronic disorder.
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Dopamine Agonists for the treatment of restless legs syndrome
Cochrane Database of Systematic Reviews, 2011Co-Authors: Hanna Scholz, Levente Kriston, Dieter Riemann, Claudia Trenkwalder, Ralf Kohnen, Magdolna HornyakAbstract:Background According to clinical guidelines, Dopamine Agonists are the first-line treatment of restless legs syndrome (RLS). Objectives To evaluate efficacy and safety of Dopamine Agonists for RLS. Search methods We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE, EMBASE, PsycINFO and CINAHL, from January 1985 to December 2008, plus reference lists of articles. We contacted pharmaceutical companies. Selection criteria We included double-blind randomised controlled trials (RCTs) of Dopamine agonist treatment versus placebo or other treatment for a period of at least seven days in patients with RLS (≥ 18 years). Outcomes included the International RLS Severity Rating Scale (IRLS), Clinical Global Impressions (CGI-I), polysomnography and self rated sleep quality, quality of life, daytime functioning, and safety parameters. Data collection and analysis Two reviewers extracted data separately; assessed risk of bias; and contacted pharmaceutical companies and authors for additional information. We collected dropout rates due to adverse events and experience of adverse events. Main results We included 35 placebo controlled and three active controlled RCTs (N = 7365). The mean reduction on the IRLS was −5.7 points lower in Dopamine agonist treatment compared to placebo (95% confidence interval (CI) −6.7 to −4.7). Periodic limb movements in sleep per hour of sleep (PLMS-Index; PLMSI) were −22.4/h lower than in placebo (95% CI −27.8 to −16.9). Self rated quality of sleep and disease specific quality of life were improved by a standardised mean difference (SMD) of 0.40 (95% CI 0.33 to 0.47) and 0.34 (95% CI 0.23 to 0.44), respectively. Patients were more likely to drop out (odds ratio (OR) 1.82, 95% CI 1.35 to 2.45) and experienced more adverse events under Dopamine agonist treatment than with placebo (OR 1.82, 95% CI 1.59 to 2.08). Visual inspection of forest plots showed the highest efficacy in three studies investigating cabergoline and pergolide (N = 3). Active controlled trials investigated effects of cabergoline, pergolide, and pramipexole in a number of outcomes. The IRLS score was lower with cabergoline and pramipexole compared to levodopa (MD −5.3, 95% CI −8.4 to −2.1). Only four studies investigated treatment efficacy up to seven months. The most severe side effect, augmentation, was not assessed reliably. Authors' conclusions The meta-analyses show the superiority of Dopamine Agonists over placebo in RCTs up to seven months. Cabergoline and pramipexole showed larger efficacy compared to levodopa in some but not all outcomes.
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Dopamine Agonists for restless legs syndrome
Cochrane Database of Systematic Reviews, 2006Co-Authors: Magdolna Hornyak, Michael M Berner, Levente Kriston, Dieter RiemannAbstract:BACKGROUND According to clinical guidelines, Dopamine Agonists are the first-line treatment of restless legs syndrome (RLS). OBJECTIVES To evaluate efficacy and safety of Dopamine Agonists for RLS. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 4), MEDLINE, EMBASE, PsycINFO and CINAHL, from January 1985 to December 2008, plus reference lists of articles. We contacted pharmaceutical companies. SELECTION CRITERIA We included double-blind randomised controlled trials (RCTs) of Dopamine agonist treatment versus placebo or other treatment for a period of at least seven days in patients with RLS (≥ 18 years). Outcomes included the International RLS Severity Rating Scale (IRLS), Clinical Global Impressions (CGI-I), polysomnography and self rated sleep quality, quality of life, daytime functioning, and safety parameters. DATA COLLECTION AND ANALYSIS Two reviewers extracted data separately; assessed risk of bias; and contacted pharmaceutical companies and authors for additional information. We collected dropout rates due to adverse events and experience of adverse events. MAIN RESULTS We included 35 placebo controlled and three active controlled RCTs (N = 7365). The mean reduction on the IRLS was -5.7 points lower in Dopamine agonist treatment compared to placebo (95% confidence interval (CI) -6.7 to -4.7). Periodic limb movements in sleep per hour of sleep (PLMS-Index; PLMSI) were -22.4/h lower than in placebo (95% CI -27.8 to -16.9). Self rated quality of sleep and disease specific quality of life were improved by a standardised mean difference (SMD) of 0.40 (95% CI 0.33 to 0.47) and 0.34 (95% CI 0.23 to 0.44), respectively. Patients were more likely to drop out (odds ratio (OR) 1.82, 95% CI 1.35 to 2.45) and experienced more adverse events under Dopamine agonist treatment than with placebo (OR 1.82, 95% CI 1.59 to 2.08). Visual inspection of forest plots showed the highest efficacy in three studies investigating cabergoline and pergolide (N = 3). Active controlled trials investigated effects of cabergoline, pergolide, and pramipexole in a number of outcomes. The IRLS score was lower with cabergoline and pramipexole compared to levodopa (MD -5.3, 95% CI -8.4 to -2.1). Only four studies investigated treatment efficacy up to seven months. The most severe side effect, augmentation, was not assessed reliably. AUTHORS' CONCLUSIONS The meta-analyses show the superiority of Dopamine Agonists over placebo in RCTs up to seven months. Cabergoline and pramipexole showed larger efficacy compared to levodopa in some but not all outcomes.
Alberto M Pereira - One of the best experts on this subject based on the ideXlab platform.
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changes in heart valve structure and function in patients treated with Dopamine Agonists for prolactinomas a 2 year follow up study
Clinical Endocrinology, 2012Co-Authors: Victoria Delgado, Nienke R Biermasz, Sjoerd W Van Thiel, See Hooi Ewe, Nina Ajmone Marsan, Eduard R Holman, Richard A Feelders, Johannes W A Smit, Jeroen J Bax, Alberto M PereiraAbstract:OBJECTIVE: The use of ergot-derived Dopamine Agonists (DA) to treat patients with prolactinomas has not been associated with an increased risk of significant heart valve dysfunction. Accordingly, the present study evaluated whether the long-term use of DA for hyperprolactinaemia may be associated with increased risk of significant valvular heart disease. METHODS: A total of 74 patients (mean age 48 +/- 1.4 years, 23% male) with prolactinoma treated with DA for at least 1 year were evaluated with 2-dimensional echocardiography at baseline. After 2 years of follow-up, a repeat echocardiography was performed to evaluate significant changes in valvular heart structure (thickening, calcifications and leaflet motion abnormalities) and function (regurgitation or stenosis). Patients were classified according to treatment: patients treated with cabergoline (group 1: n = 45), and patients not treated with cabergoline (group 2: n = 29). RESULTS: At 2-year follow-up, no significant valvular stenosis was observed in any patient. In addition, the prevalence of any significant valve regurgitation did not change significantly (from 12% to 15%, P = NS). However, there was a significant increase in the prevalence of valvular calcifications (from 48% to 58%, P = 0.004) and, particularly, in the prevalence of aortic valve calcifications (from 39% to 53%, P = 0.002). In a per-treatment-based analysis, the group of patients treated with cabergoline had significantly higher prevalence of aortic valve calcification at 2 years follow-up as compared to the group of patients not treated with cabergoline (63%vs 38%, P = 0.016). CONCLUSIONS: The long-term therapy with DA (cabergoline) of patients with prolactinoma is associated with an increased prevalence of valvular calcification. However, these structural changes were not accompanied by an increased prevalence of valvular dysfunction.
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recurrence of hyperprolactinemia after withdrawal of Dopamine Agonists systematic review and meta analysis
The Journal of Clinical Endocrinology and Metabolism, 2010Co-Authors: Olaf M Dekkers, Joep Lagro, Pia Burman, Jens Otto Lunde Jorgensen, Johannes A Romijn, Alberto M PereiraAbstract:Context: Dopamine Agonists are the treatment of choice for prolactinomas and symptomatic idiopathic hyperprolactinemia. However, the optimal treatment strategy and treatment duration is not clear in all details. Objective: The aim of the study was to assess the effect of Dopamine agonist withdrawal in patients with idiopathic hyperprolactinemia and prolactinomas. Data Sources: PubMed, the Cochrane Library, the Web of Science, and EMBASE were searched electronically. No restriction was made with respect to language. Study Selection: Studies reporting the proportion of normoprolactinemic patients after withdrawal of Dopamine agonist or studies in which this proportion could be calculated were eligible. Both observational studies and clinical trials were eligible. Nineteen studies were included in the meta-analysis, with a total of 743 patients. Data Extraction: Data extraction was performed by two reviewers independently. Data Synthesis: The pooled proportion of patients with persisting normoprolactinemia a...
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aortic valve calcification and mild tricuspid regurgitation but no clinical heart disease after 8 years of Dopamine agonist therapy for prolactinoma
The Journal of Clinical Endocrinology and Metabolism, 2008Co-Authors: Marleen Kars, Johannes A Romijn, Victoria Delgado, Eduard R Holman, Richard A Feelders, Johannes W A Smit, Jeroen J Bax, Alberto M PereiraAbstract:Objective: Treatment with ergot-derived Dopamine Agonists, pergolide, and cabergoline has been associated with an increased frequency of valvular heart disease in Parkinson’s disease. The aim of the present study was to assess the prevalence of valvular heart disease in patients treated with Dopamine Agonists for prolactinomas. Design: This was a cross-sectional study. Patients: We performed two-dimensional and Doppler echocardiography in 78 consecutive patients with prolactinoma (mean age 47 ± 1.4 yr, 26% male, 31% macroprolactinoma) treated with Dopamine Agonists for at least 1 yr (mean 8 ± 0.6 yr) and 78 control subjects. Patients were classified according to treatment: patients treated with cabergoline (group 1: n = 47) and patients not treated with cabergoline (group 2: n = 31). Results: Clinically relevant valvular heart disease was present in 12% of patients (nine of 78) vs. 17% of controls (13 of 78) (P = 0.141) and 17% (eight of 47) of patients treated with cabergoline vs. 3% (one of 31) of patie...
G. Durner - One of the best experts on this subject based on the ideXlab platform.
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Tolerability of non-ergot oral and transdermal Dopamine Agonists in younger and older Parkinson’s disease patients: an European multicentre survey
Journal of Neural Transmission, 2020Co-Authors: A. Rizos, B. Kessel, A. Sauerbier, C. Falup-pecurariu, P. Odin, A. Antonini, P. Martinez-martin, T. Henriksen, M. Silverdale, G. DurnerAbstract:In older patients with Parkinson’s disease (PD), the use of Dopamine Agonists (DA) has been limited due to uncertainties related to their tolerability in spite of potential gains with the advent of longer acting or transdermal therapies. Comparative real-life data addressing the tolerability of DA therapy across age ranges are currently sparse. This study addressed the tolerability (Shulman criteria, continued intake of DA therapy for at least 6 months) in PD patients across several European centres treated with long-acting and transdermal DA (Rotigotine skin patch, Ropinirole extended release, or Pramipexole prolonged release) as part of routine clinical care in younger and older PD patients. A medical record-based retrospective data capture and clinical interview-based follow-up survey of patients initiating or initiated on DA treatment (short and long acting) in a real-life setting. 425 cases were included [mean age 68.3 years (range 37–90), mean duration of disease 7.5 years (range 0–37), 31.5% older age (≥ 75 years of age)]. Tolerability was above 90% irrespective of age, with no significant differences between younger and older patients. Based on our findings, we suggest that long-acting/transdermal DA are tolerated in non-demented older patients, as well as in younger patients, however, with lower daily dose in older patients.
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tolerability of non ergot oral and transdermal Dopamine Agonists in younger and older parkinson s disease patients an european multicentre survey
Journal of Neural Transmission, 2020Co-Authors: A. Rizos, B. Kessel, Angelo Antonini, A. Sauerbier, P. Odin, T. Henriksen, M. Silverdale, C Faluppecurariu, Pablo Martinezmartin, G. DurnerAbstract:In older patients with Parkinson’s disease (PD), the use of Dopamine Agonists (DA) has been limited due to uncertainties related to their tolerability in spite of potential gains with the advent of longer acting or transdermal therapies. Comparative real-life data addressing the tolerability of DA therapy across age ranges are currently sparse. This study addressed the tolerability (Shulman criteria, continued intake of DA therapy for at least 6 months) in PD patients across several European centres treated with long-acting and transdermal DA (Rotigotine skin patch, Ropinirole extended release, or Pramipexole prolonged release) as part of routine clinical care in younger and older PD patients. A medical record-based retrospective data capture and clinical interview-based follow-up survey of patients initiating or initiated on DA treatment (short and long acting) in a real-life setting. 425 cases were included [mean age 68.3 years (range 37–90), mean duration of disease 7.5 years (range 0–37), 31.5% older age (≥ 75 years of age)]. Tolerability was above 90% irrespective of age, with no significant differences between younger and older patients. Based on our findings, we suggest that long-acting/transdermal DA are tolerated in non-demented older patients, as well as in younger patients, however, with lower daily dose in older patients.