iBet uBet web content aggregator. Adding the entire web to your favor.
iBet uBet web content aggregator. Adding the entire web to your favor.



Link to original content: https://www.ncbi.nlm.nih.gov/pubmed/18474889?dopt=Abstract
Effect of nonergot dopamine agonists on symptoms of restless legs syndrome - PubMed Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2008 May-Jun;6(3):253-62.
doi: 10.1370/afm.845.

Effect of nonergot dopamine agonists on symptoms of restless legs syndrome

Affiliations
Review

Effect of nonergot dopamine agonists on symptoms of restless legs syndrome

William L Baker et al. Ann Fam Med. 2008 May-Jun.

Abstract

Purpose: We performed a meta-analysis of randomized placebo-controlled trials of nonergot dopamine agonists (NEDAs) for the treatment of restless legs syndrome.

Methods: A systematic literature search was conducted through July 2007. The primary outcome measures assessed were the percentage of responders to medication as determined by the Clinical Global Impression-Improvement (CGI-I) scale and the adjusted mean change in the International Restless Legs Syndrome Study Group Scale (IRLS) score from baseline compared with placebo. Meta-regression analysis was performed to evaluate the impact of study duration on the primary outcomes. Safety endpoints were also evaluated.

Results: A total of 14 trials (n = 3,197 subjects) were included in the meta-analysis. NEDA use resulted in greater response as measured by the CGI-I scale (relative risk [RR] 1.36; 95% CI, 1.24 to 1.49; P <.001), and greater reductions in IRLS scores (weighted mean difference [WMD] -4.93; 95% CI, -6.42 to -3.43; P <.001) from baseline vs placebo. Meta-regression analysis showed an inverse relationship between study duration and reduction in IRLS score. NEDAs were associated with a significant risk of adverse events (including nausea, dizziness, somnolence, and fatigue.)

Conclusions: Use of NEDAs in patients with moderate-to-severe restless legs syndrome results in significant reductions in symptom severity, but a significant portion of patients will discontinue their use as a result of adverse events.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flow diagram of trial identification, inclusion, and exclusion. IRLS = International Restless Legs Syndrome Study Group Scale score; CGI-I = Clinical Global Impression-Improvement scale.
Figure 2.
Figure 2.
Nonergot dopamine agonist’s impact on response to clinical global impression-improvement scale (A) and International Restless Legs Syndrome Study Group Scale score (B). CI=confidence interval. Note: The squares represent individual studies and the size of the square represents the weight given to each study in the meta-analysis. Error bars represent 95% CIs. The diamond represents the combined results. The solid vertical line extending upwards from 0 (CGI) or 1 (IRLS) is the null value.
Figure 3.
Figure 3.
Subgroup and sensitivity analyses of nonergot dopamine agonists evaluating response to Clinical Global Impression-Improvement scale. CI=confidence interval; DA = dopamine agonists; ITT = intention to treat; NEDA = nonergot dopamine agonist; RR = relative risk. Note: The dashed vertical line represents the combined treatment effect for the original analysis.
Figure 4.
Figure 4.
Subgroup and sensitivity analyses of nonergot dopamine agonists evaluating mean change in International Restless Legs Syndrome Study Group scale. CI=confidence interval; DA = dopamine agonists; ITT = intention to treat; NEDA = nonergot dopamine agonist; WMD = weighted mean difference. Note: The dashed vertical line represents the combined treatment effect for the original analysis.
Figure 5.
Figure 5.
Random-effects meta-regression evaluating effect of NEDAs on mean change in IRLS (A) and CGI-I (B) over time. NEDAs = nonergot dopamine agonists; IRLS = International Restless Legs Syndrome Study Group Scale; CGI-I = Clinical Global Impression-Improvement; RR=relative risk. Note: The circles represent individual studies, and the area of the circle is proportional to the weight of each study. The dark line represents the regression equation as represented by the following equation: (A) weighted mean difference = −11.3545 + 0.6574 × study duration; (B) LnRR=0.5304–0.0219 × study duration.

Comment in

Similar articles

Cited by

References

    1. Allen RP, Walters AS, Montplaisir J, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med. 2005; 165(11):1286–1292. - PubMed
    1. Berger K, Kurth T. RLS epidemiology—frequencies, risk factors and methods in population studies. Mov Disord 2007. Jun 7; [Epub ahead of print] DOI:10.1002/mds.21589. - PubMed
    1. Lee HB, Hening WA, Allen RP, et al. Race and restless legs syndrome symptoms in an adult community sample in east Baltimore. Sleep Med. 2006; 7(8):642–645. - PubMed
    1. Dinwiddie LC. Restless legs syndrome: not just a problem for dialysis patients. ANNA J. 1997; 24(6):655–662. - PubMed
    1. Berger K, Luedemann J, Trenkwalder C, et al. Sex and the risk of restless legs syndrome in the general population. Arch Intern Med. 2004; 164(2):196–202. - PubMed

MeSH terms