Article Dans Une Revue Journal of Neurology, Neurosurgery and Psychiatry Année : 2010

Poor effect of guideline based treatment of restless legs syndrome in clinical practice

Résumé

Numerous randomized controlled trials prove efficacy of dopaminergic and non-dopaminergic drugs in the treatment of restless legs syndrome (RLS). In contrast, epidemiological data demonstrate generally insufficient RLS treatment in clinical practice. To prospectively assess the success of RLS treatment in the clinical setting and to evaluate potential demographical factors and comorbidities that may influence the response to therapy. 100 patients with idiopathic RLS (40% had never received RLS specific treatment before) were examined at baseline and after 12 months. Recommendations for therapy according to RLS treatment guidelines of the German Neurological Society were given at baseline. Primary measures for the success of therapy were reduction of RLS symptoms (IRLS) and improvement of quality of life (RLS-QoL). No statistically significant improvement of IRLS and RLS-QoL could be detected after 12 months, neither in initially untreated nor in pre-treated patients. Poor treatment success, especially regarding improvement of quality of life and number of RLS related physician contacts, was related to the presence of neuropsychiatric comorbidity, i.e. somatoform disorders (prevalence 41%), chronic pain (32%), anxiety (20%) and major depression (16%). Success of guideline conform treatment of RLS appears to be rather poor in clinical practice. Neuropsychiatric comorbidity may be a target for interventions to improve the overall outcome.

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hal-00581016 , version 1 (30-03-2011)

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Jana Godau, Nike Spinnler, Anne-Kathrin Wevers, Claudia Trenkwalder, Daniela Berg. Poor effect of guideline based treatment of restless legs syndrome in clinical practice. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 81 (12), pp.1390. ⟨10.1136/jnnp.2010.211417⟩. ⟨hal-00581016⟩

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