RT Journal Article
SR Electronic
T1 Effect of Nonergot Dopamine Agonists on Symptoms of Restless Legs Syndrome
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 253
OP 262
DO 10.1370/afm.845
VO 6
IS 3
A1 Baker, William L.
A1 White, C. Michael
A1 Coleman, Craig I.
YR 2008
UL http://www.annfammed.org/content/6/3/253.abstract
AB 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.