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Garcia-Borreguero D, Granizo J, Ferre S. 0796 Dipyridamole for the Treatment of RLS: Preliminary Results of a Cross-Over, Placebo-Controlled, Double-Blind Trial. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Recent animal models of restless legs syndrome (RLS) suggest that brain iron deficiency is associated with a hypoadenosinergic state, with downregulation of adenosine A1 receptors (A1R) in the striatum. Dipyridamole is a non-selective inhibitor of ENT1/ENT2 (the main reuptake mechanism of adenosine) and increases thereby extracellular adenosine. We hypothesized that treatment with dipyridamole would improve RLS symptoms more than placebo.
Methods
We performed a randomized, double-blind, placebo-controlled clinical trial on 15 previously untreated idiopathic RLS patients that underwent a two week treatment with either 300 mg dipyridamol or placebo (randomized for the order of treatments), following a cross-over design. Treatment started with a dose of 100 mg/day, followed by a forced up-titration to 200 mg on day 4, and to 300 mg on day 7. Severity was assessed at baseline, day 7 and day 14 of each treatment condition by means of the IRLS and CGI scales. The primary endpoint was therapeutic response (50% improvement in IRLS total score).
Results
Fifteen patients (nine women), never before treated with dopaminergic agents, completed both arms of the study. Mean age was 60,2 (±7,1), and the mean duration of illness was 6,03 (±3,1) yrs. IRLS score improved during treatment with dipyridamole from a mean (±S.D.) of 24,36 (±3,3) to 9,78 (±3,4), in contrast to a change from 23,9 (±3,8) to 16,6 (±3,7) under placebo (p< 0.05). Corresponding improvements on the CGI were 61,3% and 11,8% for dipyridamole and placebo, respectively. 7/ 15 patients improved by more than 50% during treatment with dipyridamole vs. 4/15 under placebo. Main side effects were abdominal cramps, diarrhea, dizziness, and flushing.
Conclusion
These preliminary results suggest that dipyridamole is an effective agent on RLS symptoms. It also provides evidence of hypoadenosinergic mechanisms playing a central role in RLS.
Support
No funding was provided for this investigation.
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Affiliation(s)
| | - J Granizo
- Sleep Research Institute, Madrid, SPAIN
| | - S Ferre
- Integrative Neurobiology Section, NIDA, NIH, Baltimore, MD
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Garcia-Borreguero D, Granizo J. Long-term treatment of RLS/WED with the selective glutamate ampa-receptor antagonist perampanel. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Garcia-Borreguero D, Cano I, Cruz Velarde J, Granizo J. 0748 REDUCTION IN RESPONSE TO GABAPENTIN ENACARBIL IN RLS PATIENTS PREVIOUSLY TREATED WITH DOPAMINERGIC AGENTS: A RANDOMIZED,
DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rivera J, Granizo J, Aguilar L, Giménez M, Aguiar J, Mozota J, Vos-Arenilla A, Prieto J. Analysis of the impact of a new electro-chemical activation system for potable water disinfection on the Legionella pneumophila isolation rate in a Spanish hospital. J Infect Prev 2010. [DOI: 10.1177/1757177410362497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In a field study comparing isolation rates pre- and post-installation of an electro-chemical activation system for Legionella pneumophila disinfection of potable hot water in a Spanish hospital, a total of 250 tap samples pre-installation and 113 post-installation were collected. Chlorine levels were higher ( p < 0.001) post-installation (0.55 ± 0.41 vs. 1.19 ± 0.44 ppm). Of 38.0% (138/363) samples positive for L. pneumophila, 111 (80.4%) were serogroups 2—14. Post-installation, the isolation rate was lower (46.8% vs. 18.6%; p < 0.001, odds ratio (OR) 0.26, 95% confidence interval (CI) 0.15—0.44) due to significant ( p < 0.001; OR 0.25, 95% CI 0.14—0.45) reduction in L. pneumophila serogroups 2—14 from 38.4% to 13.3%. Post-installation, isolation rates were lower in spring (44.4% vs. 0.0%; p < 0.001), summer (80.0% vs. 25.0%; p = 0.003) and autumn (72.0% vs. 28.9%; p = 0.018), but not in winter (18.5% vs. 11.8%; p = 0.688). The seasonal wave constructed with pre-installation data significantly decreased post-installation by decreasing isolation rates in summer and autumn to rates similar to those found in winter pre-installation.
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Affiliation(s)
- J.M. Rivera
- Preventive Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain, Bioseguridad Ambiental SL, Madrid, Spain
| | | | - L. Aguilar
- Microbiology Department, School of Medicine, Universidad Complutense, Avda. Complutense s/n, 28040 Madrid, Spain,
| | - M.J. Giménez
- Microbiology Department, School of Medicine, Universidad Complutense, Avda. Complutense s/n, 28040 Madrid, Spain
| | | | - J. Mozota
- Preventive Medicine Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A. Vos-Arenilla
- Nursery Department, Nursery School, Universidad Complutense, Madrid, Spain
| | - J. Prieto
- Microbiology Department, School of Medicine, Universidad Complutense, Avda. Complutense s/n, 28040 Madrid, Spain
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Murcia J, González-Comeche J, Marín A, Barberán J, Granizo J, Aguilar L, González-Moreno J, González-Pina B, López-Dupla M, Irurzun J. Clinical response to ertapenem in severe community-acquired pneumonia: a retrospective series in an elderly population. Clin Microbiol Infect 2009; 15:1046-50. [DOI: 10.1111/j.1469-0691.2009.02843.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alou L, Giménez M, Manso F, Sevillano D, Torrico M, González N, Granizo J, Bascones A, Prieto J, Maestre J, Aguilar L. Tinidazole inhibitory and cidal activity against anaerobic periodontal pathogens. Int J Antimicrob Agents 2009; 33:449-52. [DOI: 10.1016/j.ijantimicag.2008.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Revised: 10/01/2008] [Accepted: 10/06/2008] [Indexed: 11/25/2022]
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Rivera JM, Aguilar L, Granizo J, Vos-Arenilla A, Giménez MJ, Aguiar JM, Prieto J. Isolation of Legionella species/serogroups from water cooling systems compared with potable water systems in Spanish healthcare facilities. J Hosp Infect 2007; 67:360-6. [DOI: 10.1016/j.jhin.2007.07.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Accepted: 07/26/2007] [Indexed: 11/16/2022]
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Garces C, Cantos M, Benavente M, Granizo J, Cano B, Viturro E, De Oya M. 2P-0324 Variations in ApoE genotype distribution and cardiovascular disease mortality in Spain. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)90467-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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