A MULTICENTER TRIAL OF ROPINIROLE AS ADJUNCT TREATMENT FOR PARKINSONS-DISEASE

Objective: To evaluate the nonergot dopamine agonist ropinirole as an adjunct to L-dopa in a randomized, double-blind trial in PD patients w ith motor fluctuations. Background: L-dopa in the treatment of PD is a ssociated with motor fluctuations, dyskinesia, and other adverse effec ts. The use of dopamine agonists in the treatment of PD delays recours e to L-dopa and thus delays the possibility of adverse effect onset. M ethods: Ropinirole (n = 95) or placebo (n = 54) was added to L-dopa, a nd L-dopa was then reduced in a planned manner during the B-month tria l. Results: A significantly greater number of ropinirole patients were able to achieve a 20% or greater reduction in both L-dopa dose and in percent time spent ''off'' compared with placebo (35.0% versus 13.0%; p = 0.003). The mean daily L-dopa dose was reduced significantly with ropinirole treatment (242 mg versus 51 mg; p < 0.001) as was the perc ent awake time spent ''off'' (11.7% versus 5.1%; p = 0.039). There was no difference in the percent of patients who withdrew because of adve rse effects (15.8% on ropinirole versus 16.7% on placebo). Conclusions : Ropinirole permits a reduction in L-dopa dose with enhanced clinical benefit for PD patients with motor fluctuations.