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Abstract:
In previously untreated parkinsonian patients at an early stage of the disease, three comparative trials have shown that, during the first six months of treatment, the effect of ropinirole on motor symptoms almost equates to that of levodopa and is a little better than that of bromocriptine monotherapy. Until these trials have been completed (they are planned to last for 3 to 5 years), it will be impossible to know whether the postponement of dopatherapy with ropinirole administration influences the long-term outcome of Parkinson's disease. In patients already on levodopa who have mobility fluctuations, the only demonstrated effect in one trial was that the addition of ropinirole allowed the daily dose of levodopa to be reduced. However, this is a surrogate end point with no clinical relevance. A single comparative trial, versus another dopamine agonist, bromocriptine, is available, but its complex methodology makes it impossible to draw firm conclusions. The adverse effects of ropinirole are the same as those of other dopamine agonists. Again, this means that the assessment of ropinirole must continue to determine whether the drug carries an increased risk of dyskinesias or psychological effects.