Efficacy and safety of rotigotine in elderly patients with Parkinson's disease in comparison with the non-elderly: a post hoc analysis of randomized, double-blind, placebo-controlled trials.

Abstract

Rotigotine-a non-ergot dopamine agonist-has two advantages; it can stimulate all dopamine receptors (D1-D5) like innate dopamine, and its transdermal administration provides continuous dopaminergic stimulation. The age of the patient impacts the effect and adverse events of anti-parkinsonian treatment. We conducted a post hoc analysis on three randomized, double-blind, placebo-controlled trials performed in Japan to clarify the difference of anti-parkinsonian treatment in elderly and non-elderly patients. Data from two combination therapy trials (with levodopa) in advanced stage Parkinson's disease patients and one monotherapy trial in early stage patients were pooled and grouped by age (non-elderly aged < 70, elderly aged 70 +). In each age group, efficacy of rotigotine was compared to placebo. In the combination therapy, total Unified Parkinson's Disease Rating Scale Part III scores and some subtotal scores, including those for tremor, akinesia and gait disturbance, significantly improved in both elderly and non-elderly patients. Regarding safety, the incidence of total adverse event tended to be lower in elderly patients than non-elderly patients, although it was not significant. No difference was observed in maintenance dosage of rotigotine between the two groups. In conclusion, the improvement in motor symptoms and frequency of adverse events were shown to be similar in elderly and non-elderly patients with rotigotine-levodopa combination therapy. Further, there was no major difference in maintenance dosage of rotigotine between the age groups. These results suggest good tolerability of rotigotine among elderly patients.

• Authors: Masahiro Nomoto, Hirotaka Iwaki, Hiroyuki Kondo, Masaya Sakurai
• Journal: Journal of neurology (J Neurol) Vol. 265 Issue 2 Pg. 253-265 (Feb 2018) ISSN: 1432-1459 [Electronic] Germany
• PMID: 29164312 (Publication Type: Clinical Trial, Phase II, Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)

Chemical References

• Antiparkinson Agents
• Tetrahydronaphthalenes
• Thiophenes
• Levodopa
• rotigotine

Topics

• Age Factors
• Aged
• Antiparkinson Agents (therapeutic use)
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Humans
• Levodopa (therapeutic use)
• Male
• Middle Aged
• Outcome Assessment, Health Care
• Parkinson Disease (drug therapy)
• Severity of Illness Index
• Tetrahydronaphthalenes (therapeutic use)
• Thiophenes (therapeutic use)