This open-label study aimed to compare once-daily and twice-daily pramipexole extended release (PER) treatment in Parkinson�s\ndisease (PD). PD patients on dopamine agonist therapy, but with unsatisfactory control, were enrolled. Existing agonist doses were\nswitched into equivalent PER doses. Subjects were consecutively enrolled into either once-daily-first or twice-daily-first groups\nand received the prescribed amount in one or two, respectively, daily doses for 8 weeks. For the second period, subjects switched\nregimens in a crossover manner. The forty-four patients completed a questionnaire requesting preference during their last visit.\nWe measured the UPDRS-III, Hoehn and Yahr stages (H&Y) in medication-on state, Parkinson�s disease sleep scale (PDSS), and\nEpworth Sleepiness Scale. Eighteen patients preferred a twice-daily regimen, 12 preferred a once-daily regimen, and 14 had no\npreference. After the trial, 14 subjects wanted to be on a once-daily regimen, 25 chose a twice-daily regimen, and 5 wanted to\nmaintain the prestudy regimen. Main reasons for choosing the twice-daily regimen were decreased off-duration, more tolerable\noff-symptoms, and psychological stability. The mean UPDRS-III, H&Y, and PDSS were not different. Daytime sleepiness was\nsignificantly high in the once-daily regimen, whereas nocturnal hallucinations were more common in the twice-daily. Multiple\ndosing should be considered if once-daily dosing is unsatisfactory. This study is registered as NCT01515774 at ClinicalTrials.gov.
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