The Clinical Study On New Dopamine Agonist Pramipexole In The Treatment Of Parkinson's Disease

Parkinson's Disease (PD) is one kind of CNS degeneration diseases popular in the old, which is characterized by static tremor, rigidity, bradykinesia et al. Now the most popular and effective antiparkinsonian medication is levodopa. With dopaminergic therapy and the pathogenic condition progressing, curative effect decreases in most patients, the complications such as "open-off" phenomenon and end of the dose deterioration appear unavoidably, which seriously influent the life quality of Parkinsonian. Recent researches show that dopamine agonists (DA) can reduce symptoms in early PD, maybe can delay the usage of dopamine and the appearance of motor complications (fluctuations and dyskinesias); in the treatment of advanced PD as an adjunct to levodopa, DA can reduce symptoms and daily levodopa dosage. Primapexole, a new non-Ergot-DA, which is free of the severe side effects (fibrosis and valve disease) linked with ergotic DA, has less harmful effect and potential neuroprotection. Pramipexole went on sale since 2007 March in China, we firstly used it in the treament of PD,gained good effect. A group of 23 patients treated with pramipexole were designed to evaluate its efficacy and safety. According to Hoehn-Yahr scale, 23 patients are divided into 2 groups, Group A(monotherapy group),Group B(associated with levodopa).Group A were given a beginning dosage of 0.125mg three times daily(t.i.d),adding 0.375mg every week until the symptoms become stable (the max tolerated dose is 4.5mg/d).Group B were given pramipexole at the basis of the medication being taken, similar to Group A. Modified Webster Scale (MWS) and Unified Parkinson's Disease Rating Scaleâ…¢(UPDRS-â…¢) were measured before and 4 weeks after symptoms becoming stable.The results demonstrate that: In group A, MWS and UPDRS-â…¢decreased in most patients,the total effective power was 85.7%. In group B, MWS and UPDRS-â…¢decreased significantly,total effective power was 93.7%.In the patient with"on-off"phenomenon,"off"time decreased, MWS and UPDRS-â…¢decrasesd significantly in"open"time.The non-motor symptoms such as anxiety/depression, constipation, hyperhidrosis improved significantly. The first side effect was somnolence,the incidence was 27.3%, the second was indisposition of gastrointestinal tract with a incidence of 17.4%.They both disappeared or lessened in the following treament. Pramipexole can be used to treat the symptoms of Parkinson's disease safely and effectively both as monotherapy in the early stages and in the advanced phases in association with levodopa.