Rotigotine in the treatment of primary restless legs syndrome: A meta-analysis of randomized placebo-controlled trials

2015 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Jun Ding ◽  
Wei Fan ◽  
Hong-hui Chen ◽  
Peng Yan ◽  
Sheng-gang Sun ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Restless Legs

Placebo and nocebo responses in restless legs syndrome

Neurology ◽  
2017 ◽  
Vol 88 (23) ◽  
pp. 2216-2224 ◽  
Author(s):  
Maria A. Silva ◽  
Gonçalo S. Duarte ◽  
Raquel Camara ◽  
Filipe B. Rodrigues ◽  
Ricardo M. Fernandes ◽  
...  
Keyword(s):  
Adverse Events ◽  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Placebo Response ◽  
Controlled Trials ◽  
Pool Data ◽  
Double Blind ◽  
Restless Legs ◽  
Statistical Heterogeneity ◽  
Registration Number

Objective:To estimate the placebo and nocebo responses in restless legs syndrome (RLS) and explore their determinants.Methods:Databases were searched up to October 2015. Randomized, double-blind, placebo-controlled trials of patients with RLS were included if quantitative data were extractable in the placebo arm. Placebo response was defined as the within-group change from baseline, using any scale measuring RLS severity or disability. Nocebo response was defined as the proportion of patients experiencing adverse events in the placebo arm. Random-effects meta-analysis was used to pool data. Statistical heterogeneity was assessed with I2 statistic. Several predetermined subgroup and sensitivity analysis were performed. PROSPERO registration number is CRD42015027992.Results:We included 85 randomized controlled trials (5,046 participants). Pooled placebo response effect size was −1.41 (95% confidence interval [CI] −1.56 to −1.25, 64 trials, I2 = 88.1%), corresponding to −6.58 points in the International RLS Study Group Scale (IRLS). Pooled nocebo response was 45.36% (95% CI 40.47%–50.29%, 72 trials; I2 = 89.8%). The placebo and nocebo responses were greater in trials with longer duration, evaluating pharmacologic interventions and idiopathic RLS, and in industry-funded and unpublished studies. The placebo response was considerably smaller in objective as compared to subjective outcomes. In addition, the nocebo response increases proportionally with the placebo response, and has the same predictors.Conclusions:The magnitude of the placebo response in RLS is above the threshold of minimal clinical important difference, and the frequency of adverse events is also considerable. These results are relevant to inform the design and interpretation of future clinical trials.

Effect of Aerobic Exercise on Dialysis-Related Symptoms in Individuals Undergoing Maintenance Hemodialysis

2021 ◽  
Vol 16 (4) ◽  
pp. 560-574
Author(s):  
Nicholas Hargrove ◽  
Nada El Tobgy ◽  
Olivia Zhou ◽  
Mark Pinder ◽  
Brittany Plant ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Randomized Controlled Trials ◽  
Beck Depression Inventory ◽  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Maintenance Hemodialysis ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Restless Legs ◽  
Randomized Controlled

BackgroundHemodialysis is associated with a high symptom burden that impairs health-related quality of life and functional status. Effective symptom management is a priority for individuals receiving hemodialysis. Aerobic exercise may be an effective, nonpharmacologic treatment for specific hemodialysis-related symptoms. This systematic review investigated the effect of aerobic exercise on hemodialysis-related symptoms in adults with kidney failure undergoing maintenance hemodialysis.Design, setting, participants, & measurementsWe searched MEDLINE, PubMed, Cochrane CENTRAL, CINAHL, PsycINFO, SPORTDiscus, EMBASE, PEDro, and Scopus databases from 1960 or inception until April 15, 2020 for randomized controlled trials investigating the effect of aerobic exercise on hemodialysis-related symptoms, identified as prespecified primary or secondary outcomes, as compared with controls in adults on maintenance hemodialysis. We identified restless legs syndrome as the primary outcome.ResultsOf 3048 studies identified, 15 randomized controlled trials met the eligibility criteria. These studies investigated the effect of aerobic exercise on restless legs syndrome (two studies), sleep disturbance (four studies), anxiety (four studies), depression (nine studies), muscle cramping (one study), and fatigue (one study). Exercise interventions were intradialytic in ten studies and outside of hemodialysis in five studies. Heterogenous interventions and outcomes and moderate to high risk of bias precluded meta-analysis for most symptoms. Aerobic exercise demonstrated improvement in symptoms of restless legs syndrome, muscle cramping, and fatigue, as compared with nonexercise controls. Meta-analysis of depressive symptoms in studies using the Beck Depression Inventory demonstrated a greater reduction in Beck Depression Inventory score with exercise as compared with control (mean difference −7.57; 95% confidence interval, −8.25 to −6.89).ConclusionsOur review suggests that in adults on maintenance hemodialysis, aerobic exercise improves several hemodialysis-related symptoms, including restless legs syndrome, symptoms of depression, muscle cramping, and fatigue. However, the use of validated outcome measures with demonstrated reliability and responsiveness in more diverse hemodialysis populations is required to fully characterize the effect of this intervention.Clinical Trial registry name and registration number:PROSPERO #CRD42017056658

Association between restless legs syndrome and peripheral neuropathy: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Félix Javier Jiménez‐Jiménez ◽  
Hortensia Alonso‐Navarro ◽  
Elena García‐Martín ◽  
José A.G. Agúndez
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Restless Legs

We need to do better: A systematic review and meta-analysis of diagnostic test accuracy of restless legs syndrome screening instruments

2021 ◽  
Vol 58 ◽  
pp. 101461
Author(s):  
Stephany Fulda ◽  
Richard P. Allen ◽  
Christopher J. Earley ◽  
Birgit Högl ◽  
Diego Garcia-Borreguero ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Restless Legs Syndrome ◽  
Meta Analysis ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Screening Instruments ◽  
Restless Legs

Neurology: Effect of Non-Ergot Dopamine Agonists on Health-Related Quality of Life of Patients with Restless Legs Syndrome

2009 ◽  
Vol 43 (5) ◽  
pp. 813-821 ◽  
Author(s):  
Ripple Talati ◽  
Olivia J Phung ◽  
Jeffrey Mather ◽  
Craig I Coleman
Keyword(s):  
Quality Of Life ◽  
Restless Legs Syndrome ◽  
Dopamine Agonists ◽  
Meta Analysis ◽  
Health Related Quality ◽  
Restless Legs ◽  
Hrqol Data ◽  
Related Quality ◽  
Health Related

Background Non-ergot dopamine agonists (NEDAs) have become the gold-standard agents for the treatment of restless legs syndrome (RLS). While the efficacy and safety of these drugs have been widely studied, their effect on patients' health-related quality of life (HRQoL) has not been fully elucidated. Objective To better define the usefulness of NEDAs by assessing their impact on HRQoL. Methods We performed a meta-analysis of randomized, double-blind, placebo-controlled trials evaluating the use of NEDAs in patients with RLS. A systematic literature search of MEDLINE, EMBASE, and Cochrane CENTRAL was performed from the earliest possible date through July 2008. Trials were included in the analysis if they evaluated NEDAs for the treatment of RLS and reported HRQoL using any RLS disease-specific HRQoL instrument. HRQoL data were pooled and evaluated using an inverse variance weighting approach as standardized mean differences (SMDs) and 95% confidence interval (CI). For trials reporting HRQoL data obtained using the Johns Hopkins RLS-QoL Questionnaire, adjusted mean difference data were pooled to calculate the weighted mean difference (WMD) and 95% CI. Results Seven trials (N = 1483) met all inclusion criteria. Patients with RLS taking NEDAs had significantly improved overall effect on HRQoL compared with those taking placebo (SMD 0.20; 95% CI 0.10 to 0.30; degree of inconsistency across studies [I2] = 0%). When analyzing trials using the Johns Hopkins RLS-QoL questionnaire, the results also showed improvement with NEDAs compared with placebo (WMD 4.72; 95% CI 2.96 to 6.47; I2 = 0%). Study conclusions were unchanged upon sensitivity analysis. The number of trials for each NEDA was small, limiting the usefulness of between-agent comparisons. Conclusions In patients with RLS, use of NEDAs showed improved HRQoL compared with placebo. Since pooled effect sizes observed in this meta-analysis appear to surpass accepted values for minimally important clinical differences, these improvements may be clinically relevant for the average studied patient. However, future studies evaluating long-term treatment of RLS with NEDAs are necessary, as are head-to-head comparative trials and economic assessments.

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