Pramipexole in the treatment of advanced Parkinson's disease

Pramipexole is a novel nonergoline dopamine agonist with a preference for t he dopamine D-3 receptor subtype. Its efficacy and safety in the treatment of advanced Parkinson's disease has been investigated in several clinical s tudies. This review provides a summary of the data currently available, par ticularly in reference to the recent results of the European clinical phase III study and the potential tremorlytic activity of pramipexole. Interim a nalysis of the open-label European clinical phase III study has provided ev idence of long-term efficacy and safety of pramipexole. In another study pr amipexole has been shown to be significantly superior to placebo with an im provement in tremor score by 48% (vs. 13% in the placebo group). In additio n to its likely usefulness in the treatment of rest tremor in Parkinson's d isease, data suggest that pramipexole is of interest due to its reported lo w frequency of cardiovascular and gastrointestinal side-effects. However, s tudies comparing pramipexole with other antiparkinsonian agents would be us eful to further define its benefits in the treatment of tremor-dominant Par kinson's disease and to further document its favourable adverse event profi le.