PMID- 27810181
OWN - NLM
STAT- MEDLINE
DCOM- 20171218
LR  - 20181202
IS  - 1878-5506 (Electronic)
IS  - 1389-9457 (Linking)
VI  - 24
DP  - 2016 Aug
TI  - A method to switch from oral dopamine agonists to rotigotine in patients with 
      restless legs syndrome and mild augmentation.
PG  - 18-23
LID - S1389-9457(16)30051-X [pii]
LID - 10.1016/j.sleep.2016.05.004 [doi]
AB  - BACKGROUND: We examined the short- and long-term efficacy and tolerability of a 
      cross-titration algorithm from oral dopamine agonists to the rotigotine 
      transdermal patch in patients dissatisfied with their restless legs syndrome 
      (RLS) treatment, predominantly with mild augmentation. METHODS: Patients with RLS 
      (n = 20) were recruited at a single site. The cross-titration consisted of 
      decreasing oral dopaminergic agents (ropinirole by 1 mg or pramipexole by 
      0.25 mg) and increasing rotigotine by 1 mg every two days. Efficacy and adverse 
      events (AEs) were assessed at one, three, six and 12 months after the switch. 
      RESULTS: Patients had moderate-severe RLS symptoms at the baseline (mean 
      international restless legs syndrome (IRLS) score 19.4 +/- 5.5); 85% had 
      augmentation and 45% reported afternoon RLS symptoms. The baseline mean 
      pramipexole equivalent dose was 0.6 +/- 0.3 mg. At Week 5, 85% (17/20) had 
      successfully switched from their oral dopamine agonist to rotigotine (mean dose 
      2.5 +/- 0.6 mg; change in IRLS score: -6.7 +/- 8.4, p = 0.002); 14 patients were 
      CGI-I responders (much or very much improved). Three patients withdrew due to 
      lack of efficacy. Twelve months after cross-titration, 10 patients continued on 
      rotigotine, of whom four required either higher doses of rotigotine or 
      supplemental RLS medication compared with their optimal Week 5 dose; five 
      patients withdrew due to AEs and two due to lack of efficacy. CONCLUSION: A 
      cross-titration to rotigotine was efficacious after five weeks in 70% of patients 
      dissatisfied with RLS treatment, most of whom had mild augmentation. At one year 
      following the medication switch, 50% had discontinued rotigotine due to lack of 
      continued efficacy or side effects.
CI  - Copyright (c) 2016 Elsevier B.V. All rights reserved.
FAU - Winkelman, John W
AU  - Winkelman JW
AD  - Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard 
      Medical School, 1 Bowdoin Square, Boston, MA 02114, USA. Electronic address: 
      JWWINKELMAN@partners.org.
FAU - Mackie, Susan E
AU  - Mackie SE
AD  - Departments of Psychiatry and Neurology, Massachusetts General Hospital, Harvard 
      Medical School, 1 Bowdoin Square, Boston, MA 02114, USA; Department of Medicine, 
      Brigham and Women's Hospital, Harvard Medical School, 25 Shattuck Street, Boston, 
      MA 02115, USA.
FAU - Mei, Leslie A
AU  - Mei LA
AD  - Massachusetts General Hospital, 1 Bowdoin Square, Boston, MA 02114, USA.
FAU - Platt, Samuel
AU  - Platt S
AD  - Massachusetts General Hospital, 1 Bowdoin Square, Boston, MA 02114, USA.
FAU - Schoerning, Laura
AU  - Schoerning L
AD  - Marian University, 3200 Cold Spring Rd, Indianapolis, IN, USA.
LA  - eng
PT  - Journal Article
DEP - 20160623
PL  - Netherlands
TA  - Sleep Med
JT  - Sleep medicine
JID - 100898759
RN  - 0 (Benzothiazoles)
RN  - 0 (Dopamine Agonists)
RN  - 0 (Indoles)
RN  - 0 (Tetrahydronaphthalenes)
RN  - 0 (Thiophenes)
RN  - 030PYR8953 (ropinirole)
RN  - 83619PEU5T (Pramipexole)
RN  - 87T4T8BO2E (rotigotine)
SB  - IM
MH  - *Administration, Oral
MH  - Aged
MH  - Benzothiazoles/therapeutic use
MH  - Dopamine Agonists/*therapeutic use
MH  - *Drug Synergism
MH  - Female
MH  - Humans
MH  - Indoles/therapeutic use
MH  - Male
MH  - Pramipexole
MH  - Restless Legs Syndrome/*drug therapy
MH  - Severity of Illness Index
MH  - Tetrahydronaphthalenes/adverse effects/*therapeutic use
MH  - Thiophenes/adverse effects/*therapeutic use
MH  - Time Factors
MH  - Transdermal Patch
OTO - NOTNLM
OT  - Augmentation
OT  - Pramipexole
OT  - Restless legs syndrome
OT  - Ropinirole
OT  - Rotigotine
EDAT- 2016/11/05 06:00
MHDA- 2017/12/19 06:00
CRDT- 2016/11/05 06:00
PHST- 2016/02/29 00:00 [received]
PHST- 2016/04/12 00:00 [revised]
PHST- 2016/05/20 00:00 [accepted]
PHST- 2016/11/05 06:00 [pubmed]
PHST- 2017/12/19 06:00 [medline]
PHST- 2016/11/05 06:00 [entrez]
AID - S1389-9457(16)30051-X [pii]
AID - 10.1016/j.sleep.2016.05.004 [doi]
PST - ppublish
SO  - Sleep Med. 2016 Aug;24:18-23. doi: 10.1016/j.sleep.2016.05.004. Epub 2016 Jun 23.