Authors: James E Frampton
Publish Date: 2014/11/11
Volume: 74, Issue: 18, Pages: 2175-2190
Abstract
Pramipexole a nonergolinic D3preferring dopamine agonist DA is well established as a treatment option for motor symptoms at all stages of Parkinson’s disease PD It is administered orally and is available as both a threetimes daily immediaterelease IR formulation and a oncedaily extendedrelease ER formulation Mirapex® ER Mirapexin® ER Pexola® ER Sifrol® ER The two formulations are bioequivalent the majority 80 of patients can be switched overnight from pramipexole IR to ER without the need for dosage adjustment In terms of improving activities of daily living and motor function in shortterm ≤33week doubleblind studies pramipexole ER was noninferior to pramipexole IR and significantly more effective than placebo as monotherapy in patients with early PD and similar to pramipexole IR and significantly more effective than placebo as adjunctive therapy to levodopa in patients with advanced PD In longterm 80week extensions of these trials openlabel treatment with pramipexole ER was associated with sustained symptomatic benefit Moreover the majority of extension participants who responded to a simple convenience questionnaire expressed a preference for oncedaily over threetimes daily dosing Pramipexole ER was generally well tolerated in clinical trials no new or unexpected safety signals were identified compared with the IR formulation Headtohead trials are needed in order to fully define the role of pramipexole ER relative to other oncedaily formulations of DAs oral ropinirole and transdermal rotigotine Nonetheless by reducing the pill burden the ER formulation of pramipexole provides a more convenient alternative to the IR formulation studies specifically testing whether this translates into improved patient compliance and symptom control are worthwhileThe manuscript was reviewed by A Antonini Parkinson and Movement Disorders Unit IRCCS Hospital San Camillo Venice Italy SP Lloret Departments of Clinical Pharmacology and Neurosciences Toulouse University Hospital Toulouse France D Nyholm Department of Neuroscience Neurology Uppsala University Sweden F Sprenger Department of Neurology Innsbruck Medical University Innsbruck Austria C H Waters Division of Movement Disorders Columbia University College of Physicians Surgeons New York NY USAThe preparation of this review was not supported by any external funding During the peer review process the manufacturer of the agent under review was offered an opportunity to comment on this article Changes resulting from comments received were made by the authors on the basis of scientific and editorial merit James Frampton is a salaried employee of Adis/Springer
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