Rotigotine (RTG) is a non-ergot
dopamine agonist developed as a new transdermal formulation, indicated for use in early and advanced
Parkinson's disease (PD). The potential advantages of the RTG patch include immediacy of effect onset, constant
drug delivery, better tolerability avoiding
drug peaks and easy of use, helping patient's compliance. So, RTG patch appears to be a suitable candidate in the treatment of patients with atypical
parkinsonism. The present is an observational study to evaluate the efficacy and tolerability of RTG in patients affected by atypical
parkinsonian disorders. 61 subjects with diagnosis of atypical
parkinsonian disorders were treated with transdermal RTG. Diagnosis was:
Parkinson disease with
dementia,
multiple system atrophy parkinsonian type,
multiple system atrophy cerebellar type, progressive sopranuclear
palsy,
cortico-basal degeneration,
Lewy body dementia and fronto-temporal
dementia with
parkinsonism. Patients were evaluated by UPDRS-III, NPI, MMSE and adverse events (AEs) were recorded. Patients treated with RTG show an overall decrease of UPDRS III scores without increasing behavioral disturbances. Main adverse events (AE) were
hypotension (14 patients),
nausea (13),
vomiting (5), drowsiness (5),
tachycardia (2)
dystonia (3 patients, all treated with concomitant
l-dopa). On the whole, 16 patients were affected by AE and 7 patients suspended RTG treatment due to AE (
vomiting,
tachycardia and
sleepiness). In our population transdermal RTG seems to be effective and well tolerated. Due to its system of
drug delivery, RTG appears to be a suitable
therapy in elderly patients as it has a good tolerability profile, improves patient's compliance and helps management of fragile patients.