A Randomized Controlled Exploratory Pilot Study to Evaluate the Effect of Rotigotine Transdermal Patch on Parkinson's Disease–Associated Chronic Pain
Parkinson's disease, pain, dopamine receptor agonist, randomized controlled trial, pilot study
Digital Object Identifier (DOI)
Pain is a troublesome nonmotor symptom of Parkinson's disease (PD). This double-blind exploratory pilot study (NCT01744496) was the first to specifically investigate the effect of a dopamine agonist on PD-associated pain as primary outcome. Patients with advanced PD (ie, receiving levodopa) and at least moderate PD-associated chronic pain (≥3 months, ≥4 points on 11-point Likert pain scale) were randomized to rotigotine (optimal/maximum dose ≤16 mg/24h) or placebo and maintained for 12 weeks. Primary efficacy variable was change in pain severity (Likert pain scale) from baseline to end of maintenance. Secondary variables included percentage of responders (≥2-point Likert pain scale reduction), King's PD Pain Scale (KPPS) domains, and PD Questionnaire (PDQ-8). Statistical analyses were exploratory. Of 68 randomized patients, 60 (rotigotine, 30; placebo, 30) were evaluable for efficacy. A numerical improvement in pain was observed in favor of rotigotine (Likert pain scale: least-squares mean [95%CI] treatment difference, −0.76 [−1.87 to 0.34]; P = .172), and proportion of responders was 18/30 (60%) rotigotine vs 14/30 (47%) placebo. An ∼2-fold numerical improvement in KPPS domain “fluctuation-related pain” was observed with rotigotine vs placebo. Rotigotine improved PDQ-8 vs placebo (−8.01 [−15.56 to −0.46]; P = .038). These results suggest rotigotine may improve PD-associated pain; a large-scale confirmatory study is needed.
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Citation / Publisher Attribution
The Journal of Clinical Pharmacology, v. 56, issue 7, p. 852-861
Scholar Commons Citation
Rascol, Olivier; Zesiewicz, Theresa; Chaudhuri, K. Ray; Asgharnejad, Mahnaz; Surmann, Erwin; Dohin, Elisabeth; Nilius, Sigrid; and Bauer, Lars, "A Randomized Controlled Exploratory Pilot Study to Evaluate the Effect of Rotigotine Transdermal Patch on Parkinson's Disease–Associated Chronic Pain" (2016). Neurology Faculty Publications. 109.