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Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL-PET study.
- Source :
-
Annals of neurology [Ann Neurol] 2003 Jul; Vol. 54 (1), pp. 93-101. - Publication Year :
- 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
Aged
Caudate Nucleus diagnostic imaging
Caudate Nucleus metabolism
Corpus Striatum diagnostic imaging
Corpus Striatum metabolism
Disease Progression
Double-Blind Method
Female
Fluorine Radioisotopes pharmacokinetics
Humans
Male
Middle Aged
Prospective Studies
Putamen diagnostic imaging
Putamen metabolism
Severity of Illness Index
Substantia Nigra diagnostic imaging
Substantia Nigra metabolism
Brain diagnostic imaging
Brain metabolism
Dopamine metabolism
Dopamine Agonists pharmacokinetics
Dopamine Agonists therapeutic use
Indoles pharmacokinetics
Indoles therapeutic use
Levodopa pharmacokinetics
Levodopa therapeutic use
Parkinson Disease diagnostic imaging
Parkinson Disease drug therapy
Receptors, Dopamine D2 drug effects
Tomography, Emission-Computed
Subjects
Details
- Language :
- English
- ISSN :
- 0364-5134
- Volume :
- 54
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of neurology
- Publication Type :
- Academic Journal
- Accession number :
- 12838524
- Full Text :
- https://doi.org/10.1002/ana.10609