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Spotlight on Rotigotine Transdermal Patch in Parkinson’s Disease

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Abstract

Rotigotine transdermal patch (Neupro®) [referred to here as rotigotine] is a non-ergolinic dopamine agonist that is available in the EU as monotherapy for the treatment of early Parkinson’s disease and as combination therapy with levodopa throughout the course of the disease. Daily application of the rotigotine patch provided predictable release and absorption of rotigotine, with steady-state rotigotine concentrations reached within 1–2 days. In early Parkinson’s disease, compared with placebo, rotigotine monotherapy produced significantly greater improvements in the Unified Parkinson’s Disease Rating Scale summed motor and activities of daily living (ADL) scores (primary endpoint), as well as significantly higher response rates. In advanced Parkinson’s disease, rotigotine in combination with levodopa reduced ‘off’ time (primary endpoint) and improved motor functioning and ADL significantly more than levodopa plus placebo. In patients with inadequate early morning motor control despite antiparkinsonian treatment, rotigotine improved morning motor functioning and reduced sleep disturbances, night-time motor symptoms, depressive symptoms, pain and functioning, and quality of life to a significantly greater extent than placebo. The efficacy of rotigotine relative to other treatments requires further evaluation, as there were inconsistent results in noninferiority analyses that compared rotigotine to other dopamine agonists. Rotigotine was generally well tolerated across the trials, with the most common treatment-emergent adverse events being application-site reactions, gastrointestinal disturbances, somnolence and headache. No unexpected adverse effects were observed in extension studies of up to 6 years. Thus, rotigotine offers a novel approach to the treatment of Parkinson’s disease and, given its ease of administration, efficacy in reducing disabling motor and non-motor symptoms, and acceptable tolerability profile, it has the potential to be an attractive treatment option for this highly debilitating disease.

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Acknowledgements and Disclosures

The full text article[16] from which this spotlight was derived was reviewed by: J.J. Chen, Movement Disorders Center, Schools of Medicine and Pharmacy, Loma Linda University, Loma Linda, CA, USA; J.H. Friedman, Movement Disorders Program, Butler Hospital and Warren Alpert Medical School of Brown University, Providence, RI, USA; N. Ives, Birmingham Clinical Trials Unit, School of Medicine, University of Birmingham, Birmingham, UK; D. Lorenz, Department of Neurology, University of Kiel, Kiel, Germany; M. Schachter, Department of Clinical Pharmacology and Therapeutics, St Mary’s Hospital, Imperial College, London, UK. The manufacturer of the agent under review was offered an opportunity to comment on the original article[16] during the peer review process; changes based on any comments received were made on the basis of scientific and editorial merit. The preparation of the original article and this spotlight was not supported by an external funding.

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  1. Adis, a Wolters Kluwer Business, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore 0754, Auckland, New Zealand

    Mark Sanford & Lesley J. Scott

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  1. Mark Sanford
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  2. Lesley J. Scott
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Correspondence to Mark Sanford.

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Adapted and reproduced from the original article published in CNS Drugs 2011; 25 (8): 699–719.

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Sanford, M., Scott, L.J. Spotlight on Rotigotine Transdermal Patch in Parkinson’s Disease. Drugs Aging 28, 1015–1017 (2011). https://doi.org/10.2165/11207780-000000000-00000

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