Slower progression of Parkinson's disease with ropinirole versus levodopa: The REAL-PET study

Academic Article


  • Preclinical studies suggest ropinirole (a D2/D3 dopamine agonist) may be neuroprotective in Parkinson's disease (PD), and a pilot clinical study using F-dopa positron emission tomography (PET) suggested a slower loss of striatal dopamine storage with ropinirole compared with levodopa. This prospective, 2-year, randomized, double-blind, multinational study compared the rates of loss of dopamine-terminal function in de novo patients with clinical and F-dopa PET evidence of early PD, randomized 1 to 1 to receive either ropinirole of levodopa. The primary outcome measure was reduction in putamen F-dopa uptake (Ki) between baseline and 2-year PET. Of 186, 162 randomized patients were eligible for analysis. A blinded, central, region-of-interest analysis showed a significantly lower reduction (p = 0.022) in putamen Ki over 2 years with ropinirole (- 13.4%; n = 68) compared with levodopa (-20.3%; n = 59; 95% confidence interval [CI], 0.65-13.06). Statistical parametric mapping localized lesser reductions in F-dopa uptake in the putamen and substantia nigra with ropinirole. The greatest Ki decrease in each group was in the putamen (ropinirole, -14.1%; levodopa, -22.9%; 95% CI, 4.24-13.3), but the decrease was significantly lower with ropinirole compared with levodopa (p < 0.001). Ropinirole is associated with slower progression of PD than levodopa as assessed by F-dopa PET. 18 18 18 18 18
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    Author List

  • Whone AL; Watts RL; Stoessl AJ; Davis M; Reske S; Nahmias C; Lang AE; Rascol O; Ribeiro MJ; Remy P
  • Start Page

  • 93
  • End Page

  • 101
  • Volume

  • 54
  • Issue

  • 1