Evaluation of the Efficacy of Pramipexole for Treating Levodopa-induced Dyskinesia in Patients with Parkinson's Disease

Hiroya Utsumi; Yasuyuki Okuma; Osamu Kano; Yutaka Suzuki; Mutsumi Iijima; Hiroyuki Tomimitsu; Hideji Hashida; Shin-ichiro Kubo; Masahiko Suzuki; Kazunori Nanri; Miyuki Matsumura; Hidetomo Murakami; Nobutaka Hattori; on behalf of the Tokyo Parkinson's Disease Study Group

doi:10.2169/internalmedicine.52.8333

ORIGINAL ARTICLES

Evaluation of the Efficacy of Pramipexole for Treating Levodopa-induced Dyskinesia in Patients with Parkinson's Disease

Hiroya Utsumi, Yasuyuki Okuma, Osamu Kano, Yutaka Suzuki, Mutsumi Iijima, Hiroyuki Tomimitsu, Hideji Hashida, Shin-ichiro Kubo, Masahiko Suzuki, Kazunori Nanri, Miyuki Matsumura, Hidetomo Murakami, Nobutaka Hattori, on behalf of the Tokyo Parkinson's Disease Study Group

Author information

Hiroya Utsumi
Department of Neurology, Tokyo Medical University, Japan
Yasuyuki Okuma
Department of Neurology, Juntendo University Shizuoka Hospital, Japan
Osamu Kano
Department of Neurology, Toho University Omori Medical Center, Japan
Yutaka Suzuki
Division of Neurology, Department of Medicine, Nihon University School of Medicine, Japan
Mutsumi Iijima
Department of Neurology, Tokyo Women's Medical University, Japan
Hiroyuki Tomimitsu
Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Japan
Hideji Hashida
Department of Neurology, Japanese Red Cross Medical Center, Japan
Shin-ichiro Kubo
Department of Neurology, Juntendo University School of Medicine, Japan
Masahiko Suzuki
Department of Neurology, Jikei University School of Medicine, Japan
Kazunori Nanri
Department of Neurology, Tokyo Medical University Hachioji Medical Center, Japan
Miyuki Matsumura
Department of Neurology, Institute of Geriatrics, Tokyo Women's Medical University, Japan
Hidetomo Murakami
Department of Neurology, Showa University, Japan
Nobutaka Hattori
Department of Neurology, Juntendo University School of Medicine, Japan
on behalf of the Tokyo Parkinson's Disease Study Group

Keywords: dopamine agonist, dyskinesia, Parkinson's disease, pramipexole

JOURNAL OPEN ACCESS
Supplementary material

2013 Volume 52 Issue 3 Pages 325-332

DOI https://doi.org/10.2169/internalmedicine.52.8333

Details

Abstract

Objective The long-term use of levodopa to treat Parkinson's disease (PD) is often limited by the development of motor complications (e.g. levodopa-induced dyskinesia, LID). We hypothesized that a non-ergot dopamine agonist with strong affinity for D₃ dopamine receptors (pramipexole) may improve LID in patients taking an ergot D₁/D₂ dopamine agonist.
Methods Patients with PD and LID being treated with levodopa in addition to an ergot dopamine agonist were randomized to either a group in which pramipexole was added to current medications or a group in which the ergot dopamine agonist was switched to pramipexole. Dyskinesia was evaluated using Core Assessment Program for Surgical Interventional Therapies scores. The Unified Parkinson's Disease Rating Scale scores, Modified Hoehn and Yahr stages (at 'on' time), Parkinson's Disease Questionnaire-39 scores and Clinical Global Impression-Improvement scores were also used for evaluation.
Results At 24 weeks, pramipexole alleviated LID with more efficiency in the switch group.
Conclusion Pramipexole may be a therapeutic option for treating LID because its effects on D₃ dopamine receptors may balance the D₁ dopamine receptor supersensitivity associated with LID.

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