Objective: To identify demographic or clinical factors predictive of refractory cases.
Background: Restless Legs Syndrome (RLS), impacting 5-13% of the US population, poses challenges in long-term management. A knowledge gap exists in predicting resistance to first-line therapies.
Method: This retrospective study, conducted at the Parkinson’s Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas (January 2018 to September 2023) identified all patients with RLS evaluated during the pre-specified period and compared clinical and demographic data between medication-refractory group and “benign” group.
Results: Among 132 patients with RLS, 23 (17.4%) were categorized as medication-refractory. This cohort was characterized by a significantly lower mean age at onset (39.3 vs. 53.5 years), longer disease duration (26.7 vs. 14.0 years), and a higher prevalence of a positive family history of RLS among first-degree relatives compared to the “benign” group (56.5% vs. 15.5%). Furthermore, dopamine agonists were initiated as the primary medication at a significantly higher rate (p =0.006).
Conclusion: Our study found that a younger age at disease onset, prolonged disease duration, initial use of dopamine agonists, and a positive family history increased the likelihood of refractory RLS. We caution against the use of dopamine agonists in young patients with RLS. Additionally, our research suggests that botulinum toxin could be a viable second-line treatment for RLS, given its low side effect incidence, pending further confirmation of efficacy and safety through additional studies.
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To cite this abstract in AMA style:
P. Petramfar, J. Jankovic. Medication Refractory Restless Legs Syndrome: Real-World Experience [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/medication-refractory-restless-legs-syndrome-real-world-experience/. Accessed October 4, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/medication-refractory-restless-legs-syndrome-real-world-experience/