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Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL-PET study
- Source :
- Annals of Neurology. 54:93-101
- Publication Year :
- 2003
- Publisher :
- Wiley, 2003.
-
Abstract
- Preclinical studies suggest ropinirole (a D2/D3 dopamine agonist) may be neuroprotective in Parkinson's disease (PD), and a pilot clinical study using (18)F-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 (18)F-dopa PET evidence of early PD, randomized 1 to 1 to receive either ropinirole or levodopa. The primary outcome measure was reduction in putamen (18)F-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 (18)F-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 (18)F-dopa PET.
- Subjects :
- Adult
Male
Fluorine Radioisotopes
medicine.medical_specialty
Levodopa
Indoles
Parkinson's disease
Dopamine
Urology
Caudate nucleus
Severity of Illness Index
Dopamine agonist
Central nervous system disease
Double-Blind Method
Internal medicine
medicine
Humans
Prospective Studies
Aged
Receptors, Dopamine D2
Putamen
Brain
Parkinson Disease
Middle Aged
medicine.disease
Corpus Striatum
nervous system diseases
Substantia Nigra
Endocrinology
Ropinirole
Neurology
Dopamine Agonists
Disease Progression
Female
Neurology (clinical)
Caudate Nucleus
Psychology
Tomography, Emission-Computed
medicine.drug
Management of Parkinson's disease
Subjects
Details
- ISSN :
- 15318249 and 03645134
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Annals of Neurology
- Accession number :
- edsair.doi.dedup.....7c40f72d5626117a6a7a4c10bd7563e7