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. 2020 Aug 10:2020:5892163.
doi: 10.1155/2020/5892163. eCollection 2020.

A Study for Expanding Application Sites for Rotigotine Transdermal Patch

Hitoshi Kujirai  1   2 , Sakiko Itaya  1 , Yumi Ono  3 , Makoto Takahashi  1 , Akira Inaba  1 , Yasushi Shimo  2 , Nobutaka Hattori  2 , Satoshi Orimo  1
Affiliations

A Study for Expanding Application Sites for Rotigotine Transdermal Patch

Hitoshi Kujirai et al. Parkinsons Dis. .

Abstract

The rotigotine transdermal patch (RTP) is a dopamine agonist used to treat Parkinson's disease (PD). Some PD patients cannot continue RTP treatment due to application site reactions. We explored sites for RTP where application site reactions are less severe than those in the six approved application sites. Thirty PD patients (12 men, mean age = 76 years) who underwent RTP at the approved sites and had some application site reactions were enrolled in this study. When applying the RTP to the approved application sites for more than four weeks (pre-RTP) and then on the shin for the following four weeks (post-RTP), skin reactions, itching evaluated using the skin irritation score, motor symptoms, clinical global impressions scale, and plasma rotigotine concentration were examined. The mean visual analogue scale and skin irritation score in the post-RTP group were significantly lower than those in the pre-RTP group. The mean Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III score in the post-RTP group was slightly but significantly lower than that in the pre-RTP group. Plasma rotigotine concentration in the post-RTP group was slightly but significantly lower than that in the pre-RTP group. These results indicate that the shin can be a useful application site for RTP.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this manuscript.

Figures

Figure 1
Figure 1
The VAS scale was significantly lower in the post-RTP group than in the pre-RTP group (p < 0.01).
Figure 2
Figure 2
The skin irritation score of the post-RTP group was significantly lower in the pre-RTP group (p < 0.05).
Figure 3
Figure 3
The MDS-UPDRS part III score was significantly lower in the post-RTP group than that in the pre-RTP group (p < 0.05).
Figure 4
Figure 4
The CGI-I scale in the post-RTP group was minimally improved in 29%, not changed in 50%, minimally worse in 11%, and much worse in 1% relative to pre-RTP.
Figure 5
Figure 5
The mean plasma rotigotine concentration in the pre-RTP group was significantly lower than that in the post-RTP group (a) (p < 0.005). The plasma rotigotine concentration was reduced in 19, increased in two, and not changed in nine patients (b).
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