At 11:22 07/12/97 EST, MichelMarg wrote: >My understanding of the therapy is to provide the missing L-Dopa via the >Sinemet, and Requip can be used as an adjunct agonist interspersed with it. As >an agonist, it acts as a surrogate L-dopa and increases the effectiveness of >the drug. >Requip is not a substitute for L-Dopa! Here are excerpts from Canadian Press story and a press release... ============================================ TORONTO (CP)<snip> "We've developed new theories in Parkinsons disease to try to change the treatment approach and delay the onset of these troublesome side effects," said Dr. Janis Miyasaki, a Toronto neurologist. ReQuip is most beneficial to people who are diagnosed with the disease early. But those who are in the mature stage of the disease can lessen the dosage of L-dopa by taking ReQuip, Miyasaki said. "A new treatment approach is to delay the onset of use of levodopa," she said. "There is evidence in animal studies that exposure to levodopa may prime the brain to develop these side effects." ============================================= Philadelphia, PA, September 22, 1997 -- SmithKline Beecham's Requip; (ropinirole hydrochloride) received marketing clearance today from the U.S. Food and Drug Administration (FDA) for treatment of the signs and symptoms of Parkinson's disease, both as initial therapy and as adjunctive treatment with levodopa. Unlike older dopamine agonists, Requip, which is a second generation dopamine agonist, is licensed for use in patients with early Parkinson's disease (without levodopa) and in patients with advanced Parkinson's disease (with levodopa). "Requip allows physicians to delay the use of levodopa, a drug which may be associated with severe motor fluctuations after long-term use. Now these physicians can use Requip to control symptoms early in the disease or later in combination with traditional treatments. This approach will be very valuable in the management of Parkinson's disease." <snip> "It is important to recognize the value of new treatments that can be used in the early stages of Parkinson's disease," said Emilio Alonso-Mendoza, executive director, National Parkinson Foundation, Inc. "This may mean that the disease can be treated effectively over a longer period of time, improving quality of life for patients and their families. <snip> Efficacy in Early Parkinson's Disease The effects of Requip as initial dopaminergic therapy in patients with mild to moderate Parkinson's disease were assessed in a double-blind, randomized, placebo-controlled study. Results were obtained through a measurement used by physicians to assess the disease status of Parkinson's disease patients called the Unified Parkinson's Disease Rating Scale (UPDRS). Physicians measured the overall change they saw in their patients' motor function. Patients treated with Requip (n=116) demonstrated a significantly superior improvement in motor score of 24 percent compared to placebo-treated patients (n=125) who demonstrated a three percent worsening in motor score after six months. In addition, 33 percent of patients treated with Requip were rated as either "much improved" or "very much improved" on the Clinical Global Impressions (CGI) improvement item compared to 12 percent of patients given placebo. "This study shows that this new drug can improve motor function early in the disease and will therefore enable patients to maintain their active lives," said Dr. Watts. Efficacy as Adjunctive Therapy With Levodopa The efficacy of Requip as adjunctive therapy with levodopa in the late stages of Parkinson's disease was confirmed in a doubleÄblind, randomized study comparing patients treated with Requip (n=94) to patients treated with placebo (n=54). Investigators evaluated the number of "responders,"; defined as patients who were able to achieve: (1) a decrease (compared to baseline) of at least 20 percent in their levodopa dose, and (2) a decrease of at least 20 percent in the proportion of time awake in the "off" condition (period of time during the day when patients are particularly immobile). After six months, 28 percent of patients treated with Requip were classified as responders versus 11 percent of placebo-treated patients. This difference was statistically significant. In addition, 49 percent of Requip-treated patients had their levodopa dose reduced by at least 20 percent versus 17 percent of placebo-treated patients. This difference was also statistically significant. The average levodopa dose reduction was 31 percent for patients treated with Requip. This study demonstrates that the adjunctive use of Requip with levodopa allows for the reduction of a patient's levodopa dose, therefore reducing the total amount of levodopa which must be taken daily. ========================================= Judith Richards [log in to unmask]