Abstract
ObjectiveThere is still no consensus on the treatment for periodic limb movement in sleep (PLMS). This study aimed to determine the efficacy and tolerability of rotigotine in patients suffering from PLMS.MethodsPublications listed in PubMed, ScienceDirect, The Cochrane Library, and ClinicalTrials.gov were reviewed to assess the efficacy of rotigotine on PLMS. Analyses of PLMS frequency before and after rotigotine treatments (pre- and post-intervention studies) and PLMS frequency between placebo and rotigotine treatments (placebo-controlled trial studies) were included in our study. A systematic review and meta-analysis was conducted.ResultsFive publications involving 197 participants were included in this study. Among these articles, pre- and post-intervention data involving 55 participants were available from three articles, while placebo-controlled trial data from 107 participants receiving rotigotine and 70 participants receiving a placebo were available from an additional three articles. In the pre- and post-intervention studies, the periodic limb movement index was significantly decreased after therapy with rotigotine with a difference in means of −5.866/h (95% CI, −10.570 to −1.162, p = 0.015). In comparison with the placebo, the use of rotigotine significantly lowered the periodic limb movement index, with a difference in means of −32.105/h (95% CI, −42.539 to −21.671, p < 0.001), reduced the PLMS with arousal index, with a difference in means of −7.160/h (95% CI, −9.310 to −5.010, p < 0.001), and increased the withdrawal rate, with an odds ratio of 3.421 (95% CI, 1.230 to 9.512, p = 0.018).ConclusionsThis meta-analysis revealed the considerable efficacy of rotigotine in alleviating the frequency of PLMS. However, the high withdrawal rate should be taken into account.
Highlights
Periodic limb movement in sleep (PLMS), which is characterized by episodes of repetitive and stereotypical leg movements involving rhythmic extension of the big toe and dorsiflexion of the ankle with occasional concomitant knee and hip flexion, is common in the general population, with a prevalence of 5–11% [1]
In the preand post-intervention studies, the periodic limb movement index was significantly decreased after therapy with rotigotine with a difference in means of −5.866/h
Rotigotine improves periodic limb movement in sleep means of −7.160/h, and increased the withdrawal rate, with an odds ratio of 3.421
Summary
Periodic limb movement in sleep (PLMS), which is characterized by episodes of repetitive and stereotypical leg movements involving rhythmic extension of the big toe and dorsiflexion of the ankle with occasional concomitant knee and hip flexion, is common in the general population, with a prevalence of 5–11% [1]. Clinical symptoms exclusively resulting from PLMS are defined as periodic limb movement disorder (PLMD), which has a prevalence of 3.9% [1, 2]. PLMS can be recorded alone or concomitantly recorded in 27.6% of patients with obstructive sleep apnea (OSA), 70% of patients with rapid eye movement sleep behavior disorder (RBD), and 80.2% of patients with restless legs syndrome (RLS)[3,4,5,6]. To date, it is reported that pharmacological therapy is only indicated in patients with PLMD [7]
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