A five-year study of the incidence of dyskinesia in patients with early Parkinson's disease who were treated with ropinirole or levodopa
A five-year study of the incidence of dyskinesia in patients with early Parkinson's disease who were treated with ropinirole or levodopa
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DOI：
10.1056/nejm200005183422004
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发表时间：
2000-05-18
影响因子：
158.5
通讯作者：
Lang, AE
中科院分区：
文献类型：
--
作者：
Rascol, O;Brooks, DJ;Lang, AE
背景资料：有争论是否与帕金森病患者的初始治疗应该是左旋多巴或多巴胺agonist.Methods：在这个前瞻性的，随机的，双盲研究，我们比较了多巴胺D2受体激动剂罗匹尼罗的安全性和有效性与左旋多巴在5年内的268例早期帕金森病患者。如果分配的研究药物不能充分控制症状，患者可以接受补充左旋多巴，以开放标签的方式给药。主要结果测量是运动障碍的发生率。结果：罗匹尼罗组179名患者中的85名（47%）和左旋多巴组89名患者中的45名（51%）完成了所有五年的研究。在罗匹尼罗组，85名患者中有29名（34%）没有接受左旋多巴补充剂。对运动障碍发生时间的分析显示，罗匹尼罗组与对照组之间存在显著差异（运动障碍消失的风险比为2.82; 95%可信区间为1.78 - 4.44; P
Background: There is debate about whether the initial treatment for patients with Parkinson's disease should be levodopa or a dopamine agonist.Methods: In this prospective, randomized, double-blind study, we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson's disease. If symptoms were not adequately controlled by the assigned study medication, patients could receive supplementary levodopa, administered in an open-label fashion. The primary outcome measure was the occurrence of dyskinesia.Results: Eighty-five of the 179 patients in the ropinirole group (47 percent) and 45 of the 89 patients in the levodopa group (51 percent) completed all five years of the study. In the ropinirole group, 29 of the 85 patients (34 percent) received no levodopa supplementation. The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole (hazard ratio for remaining free of dyskinesia, 2.82; 95 percent confidence interval, 1.78 to 4.44; P