Abstract:

Prospective real-world data from large patient samples, which report on the long-term effectiveness of the employed different drug therapies, are rare in Parkinson’s disease (PD). The non interventional “Transdermal Rotigotine User Surveillance Study” (TRUST) trial represents such a real-world study. It investigated long-term treatment with different dopamine substituting treatment regimens in 2195 PD patients. Participation in TRUST meant that the treating neurologists were only asked to document and modify the dopaminergic drug regimen without any prior PD patient selection criteria. Thus this unique trial design reflects the real world of patient maintenance. The only intention was to follow patients in a 5:2:2:5:2 ratio for 1) rotigotine without levodopa,2) other dopamine agonists without levodopa (i.e., ropinirole,pramipexole, or other oral dopamine agonist, 3) levodopa without dopamine agonists, 4) levodopa in combination with rotigotine, or 5) levodopa in combination with other dopamine agonists. Patients were observed for ≤ 33 months.~44% of patients received the same treatment over the full duration of their participation in the study. Beneficial effects were observed with all the different therapeutic strategies employed. No clear cut differences were found.