scholarly journals The Efficacy and Safety of Pharmacological Treatments for Restless Legs Syndrome: Systemic Review and Network Meta-Analysis

2021 ◽  
Vol 15 ◽  
Author(s):  
Xuan Zhou ◽  
Juncong Du ◽  
Yi Liang ◽  
Chengcheng Dai ◽  
Lili Zhao ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Restless Legs Syndrome ◽  
Ferritin Level ◽  
Meta Analysis ◽  
Normal Serum ◽  
Systemic Review ◽  
Efficacy And Safety ◽  
Iron Supplement ◽  
Good Tolerability ◽  
Restless Legs

Although various drugs are currently used for restless legs syndrome (RLS) in clinic, selecting appropriate drugs for patients is difficult. This network meta-analysis (NMA) aimed to compare the efficacy and safety of different drugs. After literature searching and screening, 46 trials, including 10,674 participants are included in this NMA. The pooled results showed that, compared with placebo, only levodopa is inefficient to relieve symptoms of RLS. Cabergoline decreases IRLS scores to the greatest extent among all drugs (MD −11.98, 95% CI −16.19 to −7.78). Additionally, pramipexole is superior to ropinirole in alleviating symptoms of RLS (MD −2.52, 95% CI −4.69 to −0.35). Moreover, iron supplement alleviates RLS symptoms significantly compared with placebo in patient with iron deficiency (MD −5.15, 95% CI −8.99 to −1.31), but not for RLS patients with normal serum ferritin level (MD −2.22, 95% CI −6.99 to 2.56). For primary RLS, these drugs are also effective, while there is insufficient data to analyze drug efficacy in secondary RLS. We analyzed risk of common adverse effects of drugs including nausea, somnolence, fatigue, headache and nasopharyngitis. Alpha-2-delta ligands and DAs are favorable choices for both primary and secondary RLS because of their significant efficacy and good tolerability. Iron supplement can significantly alleviate symptoms of RLS patients with iron deficiency than placebo. We recommend gabapentin, gabapentin enacarbil, and pregabalin for clinicians for first consideration mainly because that they rarely cause augmentation. Oxycodone-naloxone could be considered in patients with severe or very severe RLS who failed in treatment with above drugs.

The association between obesity and restless legs syndrome: A systemic review and meta-analysis of observational studies

2018 ◽  
Vol 235 ◽  
pp. 384-391 ◽  
Author(s):  
Song Lin ◽  
Huaqi Zhang ◽  
Tianlin Gao ◽  
Feng Zhong ◽  
Yongye Sun ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Observational Studies ◽  
Meta Analysis ◽  
Systemic Review ◽  
Restless Legs

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

Comparative efficacy and safety of drug treatment for premature ejaculation: A systemic review and Bayesian network meta‐analysis

Andrologia ◽  
2020 ◽  
Vol 52 (11) ◽  
Author(s):  
Hanchao Liu ◽  
Mingxiao Zhang ◽  
Mingchuan Huang ◽  
Hongcai Cai ◽  
Yadong Zhang ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Bayesian Network ◽  
Premature Ejaculation ◽  
Meta Analysis ◽  
Systemic Review ◽  
Efficacy And Safety ◽  
Comparative Efficacy

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

scholarly journals The Safety and Efficacy of Pregabalin Add-on Therapy in Restless Legs Syndrome Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Hyoeun Bae ◽  
Yong Won Cho ◽  
Keun Tae Kim ◽  
Richard P. Allen ◽  
Christopher J. Earley
Keyword(s):  
Side Effects ◽  
Restless Legs Syndrome ◽  
Severity Index ◽  
Efficacy And Safety ◽  
Restless Legs ◽  
Persistent Symptoms ◽  
Before And After ◽  
Severity Index Score ◽  
Irls Score ◽  
Symptomatic Control

Pregabalin is increasingly being used as a first-line treatment for symptomatic control of restless legs syndrome (RLS). This study aimed to evaluate the efficacy and safety of pregabalin as add-on therapy in RLS patients already taking dopamine agonists (DA) but still in need of further management. Patients with idiopathic RLS were enrolled, and all had already been prescribed DA for at least 3 months but still had either persistent symptoms, side effects, or comorbid insomnia. An initial dose of 75 mg pregabalin was begun, adjusted as needed, and maintained at a stable dose for 4 weeks, followed by observation for a total of 8 weeks. RLS symptoms and insomnia scores were evaluated before and after add-on pregabalin treatment. Patients were monitored for side effects that could be attributed to pregabalin. A total of 32 RLS patients were enrolled, and 20 subjects remained until the endpoint. After the pregabalin add-on, the mean IRLS score showed significant improvement compared to the baseline (p < 0.001). The insomnia severity index score also improved (p = 0.036), and no serious adverse effects were observed. Our preliminary data suggests the potential for pregabalin as an add-on therapy to DA with regards to both efficacy and safety in patients who have inadequate RLS improvement.

Screening for Iron Deficiency with the Erythrocyte Protoporphyrin Test

PEDIATRICS ◽  
1983 ◽  
Vol 72 (2) ◽  
pp. 214-219
Author(s):  
Ray Yip ◽  
Samuel Schwartz ◽  
Amos S. Deinard
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Whole Blood ◽  
Ferritin Level ◽  
Lead Toxicity ◽  
Normal Serum ◽  
Erythrocyte Protoporphyrin ◽  
Age Related ◽  
Low Levels ◽  
Relationship Of

Elevation of erythrocyte protoporphyrin (EP) level is one of the consequences of iron deficiency. As the EP test has been established to be a screening test for lead poisoning, the screening capability of the EP test for iron deficiency was investigated. A total of 4,160 children between ages 6 months to 12 years had EP determined together with serum ferritin and hematocrit. Comparing the relationship of EP to serum ferritin and using a serum ferritin value ≤15 µg/L as the criterion of iron deficiency, the optimal cutoff limit for the EP test appears to be 35 µg/dL of whole blood. At this level, 88% of the subjects with low levels of serum ferritin can be detected (sensitivity), in contrast to the 53% detected at a higher cutoff value (≥50 µg/dL) used to screen for lead toxicity, or to the 59% detected by age-related hematocrit value. At an EP screening level of 35 µg/dL of whole blood, 90% of the subjects with normal serum ferritin level are correctly determined to be screen negative (specificity). The predictive value of low levels of serum ferritin for all subjects above screening level is 38%. In general, an elevated EP level, by itself, represents inadequate iron supply for hematopoiesis and signals iron deficiency regardless of whether the serum ferritin value is below the diagnostic level or not. A trial course of orally administered iron is suggested for children who are found to have an elevated EP value, with an increase in hemoglobin or hematocrit value serving, retrospectively, as confirmation of prior iron deficiency.

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