Rotigotine transdermal patch attenuates freezing of gait during wearing off in patients with Parkinson’s disease (P1.022)

Objective: To examine how non-ergot dopamine receptor agonist (DA) treatment with rotigotine, pramipexole LA or ropinirole CR influences freezing of gait (FOG) in patients with Parkinson’s disease (PD). Background: FOG develops frequently in advanced PD patients. Rotigotine transdermal patch maintains effective serum concentrations for 24-hours. Little is known about therapeutic effects of rotigotine on FOG in PD patients. Design/Methods: PD patients were fulfilled the following criteria; age > 40 years, Hoehn & Yahr stage of 3–4, Unified PD Rating Scale (UPDRS) III score > 10, and no prior use of non-ergot DAs. Rotigotine (4–12 mg/24-hours), pramipexole LA (1.5–4.5 mg/day) or ropinirole CR (8–16 mg/day) was administered randomly. The doses of levodopa and other anti-parkinsonian medications were not changed for 28 days before and during the study. Active gait physiotherapy finished before this study. UPDRS I–IV scores on time, FOG questionnaire (Giladi et al. 2000) during off time were examined from baseline to 7 months after DA administration. Results: One hundred eleven patients completed the study. There were no significant changes of clinical profiles between patients with rotigotine (n=47), pramipexole LA (n=33) and ropinirole CR (n=31). UPDRS II–III scores and wearing off time were significantly reduced after each DA treatment compared to baseline. FOG was found in 54/111 patients (49%), including 24/47 (51%) in the rotigotine group, 16/33 (48%) in the pramipexole LA group and 14/31 (45%) in the ropinirole CR group. FOG occurred during off time in 48 patients, and on and off time in 6 patients. FOG scores were significantly decreased from 2 months after rotigotine treatment. Pramipexole LA or ropinirole CR treatment did not alter FOG scores. Conclusions: Rotigotine treatment attenuated wearing off-associated FOG in PD patients. The similar binding affinities to dopamine receptors between rotigotine and dopamine, and 24-hours steady hemodynamics could contribute to the therapeutic mechanism of rotigotine on FOG. Disclosure: Dr. Ikeda has nothing to disclose. Dr. Kano has nothing to disclose. Dr. Kawabe has nothing to disclose. Dr. Takazawa has nothing to disclose. Dr. Hirayama has nothing to disclose. Dr. Yanagihashi has nothing to disclose. Dr. Miura has nothing to disclose. Dr. Ishikawa has nothing to disclose. Dr. Ebina has nothing to disclose. Dr. Kyuzen has nothing to disclose. Dr. Nagasawa has nothing to disclose. Dr. Sawada has nothing to disclose. Dr. Hanashiro has nothing to disclose. Dr. Morioka has nothing to disclose. Dr. Iwasaki has nothing to disclose.