Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study

Objective. To explore the efficacy and safety of pramipexole sustained release (SR) versus pramipexole immediate release (IR) in treating nocturnal symptoms in levodopa-treated Chinese patients with advanced Parkinson’s disease (PD) and sleep disturbances. Method. SUSTAIN was an open-label, randomis...

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Main Authors: Haiyan Zhou, Shuhua Li, Hongmei Yu, Shenggang Sun, Xinhua Wan, Xiaodong Zhu, Chun-Feng Liu, Ling Chen, Wei Xiang, Yaqing Sun, Haibo Chen, Shengdi Chen
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Parkinson's Disease
Online Access:http://dx.doi.org/10.1155/2021/8834950
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author Haiyan Zhou
Shuhua Li
Hongmei Yu
Shenggang Sun
Xinhua Wan
Xiaodong Zhu
Chun-Feng Liu
Ling Chen
Wei Xiang
Yaqing Sun
Haibo Chen
Shengdi Chen
author_facet Haiyan Zhou
Shuhua Li
Hongmei Yu
Shenggang Sun
Xinhua Wan
Xiaodong Zhu
Chun-Feng Liu
Ling Chen
Wei Xiang
Yaqing Sun
Haibo Chen
Shengdi Chen
author_sort Haiyan Zhou
collection DOAJ
description Objective. To explore the efficacy and safety of pramipexole sustained release (SR) versus pramipexole immediate release (IR) in treating nocturnal symptoms in levodopa-treated Chinese patients with advanced Parkinson’s disease (PD) and sleep disturbances. Method. SUSTAIN was an open-label, randomised, active-controlled parallel group exploratory pilot study (NCT03521635). A total of 98 patients were randomly allocated (1 : 1) to either pramipexole SR (n = 49) or pramipexole IR (n = 49) groups. The primary endpoint was a change from baseline in PD Sleep Scale 2nd version (PDSS-2) total score at 18 weeks. A reduction in score represents improvement. Secondary endpoints included Nocturnal Hypokinesia Questionnaire, Scales for Outcomes in PD Sleep Scale, Early Morning Off (EMO), Epworth Sleepiness Scale, PD Questionnaire-8, and responder rates as measured by PDSS-2 total score (<18), EMO scores (≥1 point change), Clinical Global Impression Improvement scale, and Patient Global Impression-Improvement scale. Other endpoints included motor complications (MDS-UPDRS part IV) score. Adverse events were evaluated for each group. Results. The mean pramipexole dose for both groups was 1.5 mg/day at week 18, and the mean changes in PDSS-2 total score for pramipexole SR and IR were –13.7 (95% CI –16.0 to –11.4) and –14.4 (–16.8 to –12.0) (difference of 0.7; p=0.688). Change from baseline for both groups achieved the minimal clinical important difference threshold (MCID = –3.44). No significant difference was observed in change from baseline for other measures of sleep-related disturbances or responder rates. For motor complications, a greater improvement in MDS-UPDRS part IV score was observed in pramipexole SR over IR (–3.4 vs –2.3; treatment group difference: –1.1; p=0.036). Both groups had comparable safety profiles. Conclusion. In Chinese patients with advanced PD and sleep disturbances, pramipexole SR and IR have similar benefits in the treatment of nocturnal symptoms and safety, and an improvement from baseline in nocturnal symptoms was observed regardless of pramipexole formulation.
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spelling doaj-art-97f90358dbe049e4b30fb0425150e9e82025-02-03T01:24:12ZengWileyParkinson's Disease2090-80832042-00802021-01-01202110.1155/2021/88349508834950Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot StudyHaiyan Zhou0Shuhua Li1Hongmei Yu2Shenggang Sun3Xinhua Wan4Xiaodong Zhu5Chun-Feng Liu6Ling Chen7Wei Xiang8Yaqing Sun9Haibo Chen10Shengdi Chen11Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, ChinaDepartment of Neurology, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Neurology, Wuhan Union Hospital, Wuhan, ChinaDepartment of Neurology, Peking Union Medical College Hospital, Beijing, ChinaDepartment of Neurology, Tianjin Medical University General Hospital, Tianjin, ChinaDepartment of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Neurology, The First Affiliated Hospital, Sun Yet-Sen University, Guangzhou, ChinaBoehringer Ingelheim (China), Shanghai, ChinaBoehringer Ingelheim (China), Shanghai, ChinaDepartment of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, ChinaDepartment of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaObjective. To explore the efficacy and safety of pramipexole sustained release (SR) versus pramipexole immediate release (IR) in treating nocturnal symptoms in levodopa-treated Chinese patients with advanced Parkinson’s disease (PD) and sleep disturbances. Method. SUSTAIN was an open-label, randomised, active-controlled parallel group exploratory pilot study (NCT03521635). A total of 98 patients were randomly allocated (1 : 1) to either pramipexole SR (n = 49) or pramipexole IR (n = 49) groups. The primary endpoint was a change from baseline in PD Sleep Scale 2nd version (PDSS-2) total score at 18 weeks. A reduction in score represents improvement. Secondary endpoints included Nocturnal Hypokinesia Questionnaire, Scales for Outcomes in PD Sleep Scale, Early Morning Off (EMO), Epworth Sleepiness Scale, PD Questionnaire-8, and responder rates as measured by PDSS-2 total score (<18), EMO scores (≥1 point change), Clinical Global Impression Improvement scale, and Patient Global Impression-Improvement scale. Other endpoints included motor complications (MDS-UPDRS part IV) score. Adverse events were evaluated for each group. Results. The mean pramipexole dose for both groups was 1.5 mg/day at week 18, and the mean changes in PDSS-2 total score for pramipexole SR and IR were –13.7 (95% CI –16.0 to –11.4) and –14.4 (–16.8 to –12.0) (difference of 0.7; p=0.688). Change from baseline for both groups achieved the minimal clinical important difference threshold (MCID = –3.44). No significant difference was observed in change from baseline for other measures of sleep-related disturbances or responder rates. For motor complications, a greater improvement in MDS-UPDRS part IV score was observed in pramipexole SR over IR (–3.4 vs –2.3; treatment group difference: –1.1; p=0.036). Both groups had comparable safety profiles. Conclusion. In Chinese patients with advanced PD and sleep disturbances, pramipexole SR and IR have similar benefits in the treatment of nocturnal symptoms and safety, and an improvement from baseline in nocturnal symptoms was observed regardless of pramipexole formulation.http://dx.doi.org/10.1155/2021/8834950
spellingShingle Haiyan Zhou
Shuhua Li
Hongmei Yu
Shenggang Sun
Xinhua Wan
Xiaodong Zhu
Chun-Feng Liu
Ling Chen
Wei Xiang
Yaqing Sun
Haibo Chen
Shengdi Chen
Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study
Parkinson's Disease
title Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study
title_full Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study
title_fullStr Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study
title_full_unstemmed Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study
title_short Efficacy and Safety of Pramipexole Sustained Release versus Immediate Release Formulation for Nocturnal Symptoms in Chinese Patients with Advanced Parkinson’s Disease: A Pilot Study
title_sort efficacy and safety of pramipexole sustained release versus immediate release formulation for nocturnal symptoms in chinese patients with advanced parkinson s disease a pilot study
url http://dx.doi.org/10.1155/2021/8834950
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