Premium
Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL‐PET study
Author(s) -
Whone Alan L.,
Watts Ray L.,
Stoessl A. Jon,
Davis Margaret,
Reske Sven,
Nahmias Claude,
Lang Anthony E.,
Rascol Olivier,
Ribeiro Maria J.,
Remy Philippe,
Poewe Werner H.,
Hauser Robert A.,
Brooks David J.
Publication year - 2003
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.10609
Subject(s) - ropinirole , levodopa , putamen , parkinson's disease , medicine , dopamine agonist , dopamine , psychology , gastroenterology , dopaminergic , disease
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. Ann Neurol 2003