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

被引：197
作者：
Garcia-Borreguero, Diego [1 ]
Kohnen, Ralf [2 ,3 ]
Silber, Michael H. [4 ,5 ,6 ]
Winkelman, John W. [7 ,8 ]
Earley, Christopher J. [9 ,10 ]
Hoegl, Birgit [11 ]
Manconi, Mauro [12 ]
Montplaisir, Jacques [13 ,14 ]
Inoue, Yuichi [15 ,16 ]
Allen, Richard P. [9 ,10 ]
机构：
[1] Sleep Res Inst, Madrid 28036, Spain
[2] Res Pharmaceut Serv Inc, Ft Washington, PA USA
[3] Univ Erlangen Nurnberg, Dept Psychol, Nurnberg, Germany
[4] Mayo Clin, Coll Med, Rochester, MN USA
[5] Mayo Clin, Ctr Sleep Med, Rochester, MN USA
[6] Mayo Clin, Dept Neurol, Rochester, MN USA
[7] Harvard Univ, Sch Med, Boston, MA USA
[8] Brigham & Womens Hosp, Dept Med, Div Sleep Med, Boston, MA 02115 USA
[9] Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA
[10] Johns Hopkins Bayview Med Ctr, Sleep Disorders Ctr, Baltimore, MD USA
[11] Med Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, Austria
[12] Civ Hosp, Neuroctr Southern Switzerland, Sleep & Epilepsy Ctr, Lugano, Switzerland
[13] Univ Montreal, Dept Psychiat, Montreal, PQ H3C 3J7, Canada
[14] Univ Montreal, Dept Neurosci, Montreal, PQ, Canada
[15] Neuropsychiat Res Inst, Japan Somnol Ctr, Tokyo, Japan
[16] Tokyo Med Univ, Dept Somnol, Tokyo 1608402, Japan
来源：
SLEEP MEDICINE | 2013年 / 14卷 / 07期
关键词：
Restless legs syndrome; Willis-Ekbom disease; Pharmacologic therapy; Periodic limb movements of sleep; Calcium channel alpha 2 delta ligands; Opioids; Hypnotics and sedatives; Dopamine agents; QUALITY-OF-LIFE; OPEN-LABEL; DOUBLE-BLIND; GABAPENTIN ENACARBIL; DOPAMINERGIC TREATMENT; CARDIAC VALVULOPATHY; PRACTICE PARAMETERS; FOLLOW-UP; PRAMIPEXOLE; MANAGEMENT;
D O I：
10.1016/j.sleep.2013.05.016
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
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 6 months or longer presented at meetings over the past 2 years, 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 1 year in treating RLS/WED (Level A evidence). Pramipexole, ropinirole, and rotigotine have been established as effective for up to 6 months 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 5 years: gabapentin enacarbil, pramipexole, and ropinirole (1 year); levodopa (2 years); and rotigotine (5 years). 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 alpha(2)delta 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. (c) 2013 Elsevier B.V. All rights reserved.
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页码：675 / 684
页数：10
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