The long-term treatment of restless legs syndrome/Willis–Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: a report from the International Restless Legs Syndrome Study Group

A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) to develop evidence-based and consensus-based recommendations for the long-term pharmacologic treatment of restless legs syndrome/Willis–Ekbom disease (RLS/WED). The Task Force reviewed the results of all s...

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Vydané v:Sleep medicine Ročník 14; číslo 7; s. 675 - 684
Hlavní autori: Garcia-Borreguero, Diego, Kohnen, Ralf, Silber, Michael H., Winkelman, John W., Earley, Christopher J., Högl, Birgit, Manconi, Mauro, Montplaisir, Jacques, Inoue, Yuichi, Allen, Richard P.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Netherlands Elsevier B.V 01.07.2013
Predmet:
Calcium channel alpha 2 delta ligands
Calcium Channel Blockers - therapeutic use
Consensus
Dopamine agents
Dopamine Agonists - therapeutic use
Evidence-Based Medicine - standards
Humans
Hypnotics and sedatives
Hypnotics and Sedatives - therapeutic use
Internationality
Neurology
Opioids
Periodic limb movements of sleep
Pharmacologic therapy
Practice Guidelines as Topic
Restless legs syndrome
Restless Legs Syndrome - drug therapy
Sleep Medicine
Willis–Ekbom disease
Restless legs syndrome
Dopamine agents
Pharmacologic therapy
Calcium channel alpha 2 delta ligands
Opioids
Willis–Ekbom disease
Periodic limb movements of sleep
Hypnotics and sedatives
ISSN:1389-9457, 1878-5506, 1878-5506
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Shrnutí:A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) to develop evidence-based and consensus-based recommendations for the long-term pharmacologic treatment of restless legs syndrome/Willis–Ekbom disease (RLS/WED). The Task Force reviewed the results of all studies of RLS/WED treatments with durations of 6months or longer presented at meetings over the past 2years, posted on Web sites of pharmaceutical companies, or published in peer-reviewed journals, asking the questions, “What is the efficacy of this treatment in patients with RLS/WED?” and “What is the safety of this treatment in patients with RLS/WED?” The Task Force developed guidelines based on their review of 61 papers meeting inclusion criteria, and using a modified evidence-grading scheme. Pregabalin has been established as effective for up to 1year in treating RLS/WED (Level A evidence). Pramipexole, ropinirole, and rotigotine have been established as effective for up to 6months in treating RLS/WED (Level A). The following drugs have been established as probably effective (Level B) in treating RLS/WED for durations ranging from 1 to 5years: gabapentin enacarbil, pramipexole, and ropinirole (1year); levodopa (2years); and rotigotine (5years). Because of associated safety concerns, pergolide and cabergoline should not be used in the treatment of RLS/WED unless the benefits clearly outweigh the risks. Other pharmacologic therapies have insufficient evidence to support their long-term use in treating RLS/WED. The IRLSSG Task Force also developed consensus-based strategies for the prevention and treatment of complications (such as augmentation, loss of efficacy, excessive daytime sleepiness, and impulse control disorders) that may develop with the long-term pharmacologic treatment of RLS/WED. The use of either a dopamine-receptor agonist or α2δ calcium-channel ligand is recommended as the first-line treatment of RLS/WED for most patients, with the choice of agent dependent on the patient’s severity of RLS/WED symptoms, cognitive status, history, and comorbid conditions.
Bibliografia:SourceType-Scholarly Journals-1
ObjectType-News-1
ObjectType-Feature-4
ObjectType-Conference-2
content type line 23
ObjectType-Article-3
ISSN:1389-9457
1878-5506
1878-5506
DOI:10.1016/j.sleep.2013.05.016