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Published online: 26 June 2019
© Springer Nature Switzerland AG 2019
Abstract
Rotigotine (Neupro®), a non-ergolinic dopamine agonist (DA), is administered once daily via a transdermal patch (TP) that delivers the drug over a 24-h period. In the EU, the rotigotine TP is approved as monotherapy for the treatment of early Parkinson's disease (PD) and as combination therapy with levodopa throughout the course of the disease. It is also approved for the treatment of PD in numerous other countries, including Australia, the USA, China and Japan. Rotigotine TP effectively improved motor and overall functioning in clinical trials in Caucasian and Asian patients with early PD (as monotherapy) or advanced PD (in combination with levodopa); treatment benefits appeared to be maintained in open-label extensions that followed patients for up to 6 years. Rotigotine TP was not consistently non-inferior to ropinirole and pramipexole in studies that included these oral non-ergolinic DAs as active comparators. Rotigotine TP variously improved some non-motor symptoms of PD, in particular sleep disturbances and health-related quality of life (HRQOL), based on findings from individual studies and/or a meta-analysis. Rotigotine TP was generally well tolerated, with an adverse event profile characterized by adverse events typical of dopaminergic stimulation and transdermal patch application. Available for more than a decade, rotigotine TP is a well-established, once-daily DA formulation for use in the short- and longer-term treatment of PD. It offers a convenient alternative when non-oral administration of medication is preferred and may be particularly useful in patients with gastrointestinal disturbances that reduce the suitability of oral medication.
1Introduction
Parkinson's disease (PD) is a chronic, progressive neurodegenerative disorder characterized clinically by a heterogeneous combination of motor and non-motor symptoms that variously contribute to severe disability, impaired quality of life and shortened life expectancy [1, 2]. Non-motor symptoms of PD are highly prevalent and include sleep disturbances, mood and behavioural disorders, autonomic [including gastrointestinal (GI)] dysfunction and pain [2]. Recognition of their importance has increased in recent years; there are reports that they have an even greater impact on health-related quality of life (HRQOL) than classical motor symptoms [3, 4].
Dopaminergic agents continue to be the cornerstone of the medical management of the motor symptoms of PD, which are closely linked to the preferential degeneration of substantia...