Dosing with ropinirole in a clinical setting

Objectives - To determine the optimal dose of ropinirole (ReQuip®) for treatment of early Parkinson's disease (PD). Materials and methods - Six-month data were gathered from three trials of monotherapy in patients with PD. Results - Seventy-five percent of patients who experienced a therapeutic response did so at ≤ 7.5 mg/day. Patients whose dose was increased by more than four titration levels from weeks 4-24 (mean total increase 14.8 mg/day) tended to show greater improvements than those whose dose increase was smaller (mean increase 3.4 mg/day) (17.4% vs 10.8%, respectively). Mean doses continued to increase throughout the 3- and 5-year trials (3-year trial at endpoint, 10.4 mg/day; 5-year trial at 3 years and at endpoint, 14.1 and 14.9 mg/day, respectively). Conclusion - Although a therapeutic response may be expected at ≤ 7.5 mg/day, these data suggest a benefit for continued dose titration in most patients with early PD. For some patients, the maximum recommended dose (24 mg/day) may be necessary.