Role of Pramipexole in the Management of Parkinson’s Disease
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The non-ergot dopamine agonist pramipexole is currently indicated for the treatment of the signs and symptoms of idiopathic Parkinson’s disease and for the treatment of moderate-to-severe primary restless legs syndrome. A new extended-release formulation of pramipexole has now also been launched in Europe and the US to improve ease of use, compliance and provide a more continuous therapeutic effect over 24 hours. Before initiating any treatment, the benefit-risk ratio to the individual patient must be considered. For pramipexole in the treatment of Parkinson’s disease, this means taking into account the available evidence regarding its symptomatic efficacy, effect on delaying long-term levodopa-related motor complications, beneficial effect on non-motor symptoms such as depression, and its safety and tolerability profile. Studies have shown that pramipexole is effective as monotherapy in early Parkinson’s disease and as adjunctive therapy in advanced disease. Trials further suggest that the benefits of pramipexole may extend beyond the relief of motor symptoms (akinesia, rigidity and tremor at rest) to the amelioration of depressive symptoms in Parkinson’s disease. Pramipexole is generally well tolerated; however, compared with levodopa treatment, pramipexole is associated with a higher rate of some dopaminergic adverse effects
Angelo Antonini has received honoraria for consulting services and symposia from Abbott, Boehringer Ingelheim, GlaxoSmithKline, Lundbeck, UCB, Novartis and Merck-Serono.
Gianni Abbruzzese has received honoraria for symposia from Novartis, Lundbeck, GlaxoSmithKline, UCB, Boehringer-Ingelheim and has been an advisory board member for Boehringer-Ingelheim.
Paolo Barone has received compensation for consulting services and research support from Boehringer Ingelheim, and payment for consulting services and symposia from Novartis, UCB, Merck-Serono, Eisai, Solvay, General Electric and Lundbeck.
Giovanni Fabbrini has received honoraria for symposia from Novartis, Lundbeck, GlaxoSmithKline and Boehringer-Ingelheim and has been an advisory board member for Boehringer-Ingelheim.
Roberto Ceravolo has received honoraria for symposia from Novartis, Lundbeck, GlaxoSmithKline, UCB and Boehringer-Ingelheim and has been on advisory boards for General Electric and Boehringer-Ingelheim.
Michele Tinazzi has received honoraria for Symposia and has been an advisory board member for Boehringer Ingelheim.
Editorial assistance (editing and referencing) was provided by Anita Chadha-Patel, PhD, who was supported by an unrestricted grant from the Neureca Foundation for movement disorders, Milan, Italy. No other sources of funding were used to prepare this review.
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