The Impact of Rotigotine on Cardiovascular Autonomic Function in Early Parkinson’s Disease

Abstract

Dysautonomia can occur in early stages of Parkinson’s disease (PD) influencing tolerance to dopaminergic therapies. Rotigotine, a non-ergot dopamine agonist, has recently been developed as an effective alternative antiparkinsonian drug, but its influence on the autonomic nervous system was not investigated. Twenty subjects out of 34 consecutive de novo PD patients were submitted to full assessment of cardiovascular autonomic function before and after reaching a stable rotigotine regimen [6 mg/24 h (n = 3) or 8 mg/24 h (n = 17)]. Patients reached significant clinical improvement (–27% on the Unified Parkinson’s Disease Rating Scale part III) and did not show significant differences in cardiovascular tests compared to baseline data. However, an unexpected trend towards increasing systolic blood pressure after head-up tilt test was detected. Our study demonstrates that rotigotine does not influence cardiovascular autonomic responses in early de novo PD patients. Consequently, it may represent a well-tolerated and efficacious therapeutic option in newly diagnosed PD subjects.

Autonomic Function Tests and MIBG in Parkinson's Disease: Correlation to Disease Duration and Motor Symptoms

“…Respiration rate was also monitored continuously using a nasal thermocouple respiration flow sensor (SleepSense ® ). AFTs were performed using standard procedures . The results of each test were automatically calculated by means of Light‐SNV software ® .…”

Efficacy and safety of rotigotine in elderly patients with Parkinson’s disease in comparison with the non-elderly: a post hoc analysis of randomized, double-blind, placebo-controlled trials

“…It is reported that dopamine receptors (D1–D5) are specifically involved in the regulation of blood pressure [ 22 ]. In addition, rotigotine is reported not to influence cardiovascular autonomic responses in de novo PD patients [ 23 ]. Consequently, the major reason for the improvement of postural instability and ADLs in patients treated with rotigotine in this study could be due to lower occurrence of these AEs and the pharmacological property of rotigotine that includes a well-balanced response to all dopamine receptors.…”

Recognition and treatment of autonomic disturbances in Parkinson’s disease

“…In another study, 5% of the subjects in the ropinirole 24-h prolonged release group had OH, while 2% of the placebo group had OH. Rotigotine showed no influence on cardiovascular autonomic function in PD in a recent study [80]. Further studies on the influence of anti-PD medication to the cardiovascular autonomic function, especially those using comprehensive examinations, are warranted.…”