Treatment of moderate to severe restless legs syndrome: 2-year safety and efficacy of rotigotine transdermal patch.

Abstract

BACKGROUND:

Rotigotine is a unique dopamine agonist with activity across D1 through D5 receptors as well as select adrenergic and serotonergic sites. This study reports the 2-year follow-up safety and efficacy data of an ongoing open-label multicenter extension study (NCT00498186) of transdermal rotigotine in patients with moderate to severe restless legs syndrome (RLS).

METHODS:

Patients received a once-daily patch application of an individually optimized dose of rotigotine between 0.5 mg/24 h to 4 mg/24 h. Safety assessments included adverse events (AEs) and efficacy was measured by the International RLS Study Group Severity Rating Scale (IRLS), RLS-6 scales and Clinical Global Impression (CGI). Quality of life (QoL) was measured by QoL-RLS.

RESULTS:

Of 310 patients who completed a 6-week placebo-controlled trial (SP709), 295 (mean age 58 ± 10 years, 66% females) were included in the open-label trial SP710. 64.7% (190/295 patients) completed the 2-year follow-up; 29 patients discontinued during the second year. Mean daily rotigotine dose after 2 years was 2.93 ± 1.14 mg/24 h with a 2.9% dose increase from year 1. Rotigotine was generally well tolerated. The rate of typical dopaminergic side effects, nausea and fatigue, was low (0.9% and 2.3%, respectively) during the second year; application site reactions were frequent but lower than in year 1 (16.4% vs. 34.5%). The IRLS total score improved from baseline of SP709 (27.8 ± 5.9) by 17.2 ± 9.2 in year 2 completers. Similar improvements were observed in RLS-6 scales, CGI scores and QoL-RLS. The responder rate in the CGI change item 2 ("much" and "very much" improved) was 95% after year 2.

CONCLUSIONS:

Transdermal rotigotine is an efficacious and well-tolerated long-term treatment option for patients with moderate to severe RLS with a high retention rate during 2 years of therapy.

TRIAL REGISTRATION:

NCT00498186.

• Authors: Birgit Högl, Wolfgang H Oertel, Karin Stiasny-Kolster, Peter Geisler, Heike Beneš, Diego García-Borreguero, Claudia Trenkwalder, Werner Poewe, Erwin Schollmayer, Ralf Kohnen
• Journal: BMC neurology (BMC Neurol) Vol. 10 Pg. 86 (Sep 28 2010) ISSN: 1471-2377 [Electronic] England
• PMID: 20920156 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Dopamine Agonists
• Tetrahydronaphthalenes
• Thiophenes
• rotigotine

Topics

• Adult
• Aged
• Dopamine Agonists (administration & dosage, adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Patient Compliance
• Restless Legs Syndrome (drug therapy)
• Tetrahydronaphthalenes (administration & dosage, adverse effects)
• Thiophenes (administration & dosage, adverse effects)
• Transdermal Patch
• Young Adult