Case Study 1

Maria is a 47-year-old Hispanic female with hypertension and gastroesophageal reflux disease (GERD) who has been receiving treatment for insomnia*

Chief Complaint

Patient states she is able to sleep, but wakes up feeling unrefreshed; also reports tingling and twitching sensations in her legs in the evening.

*Not an actual patient. This case study is presented as an example.

Medical History

• Hypertension diagnosed 2 years ago
• Insomnia diagnosed 1 month ago
• GERD diagnosed 1 year ago

Social History

• Telemarketer
• Married with 2 children

Current Medications

• losartan potassium 50 mg once daily
• esomeprazole magnesium 40 mg once daily
• eszopicline 2 mg once daily

Physical Exam

• Within normal limits

History of Current Illness

Upon further evaluation, patient is experiencing an urge to move legs in the evening, which occurs at rest and is relieved by movement

Making a Differential Diagnosis

People often report problems with sleeping that can be caused by a number of different health conditions. While these conditions may have some symptoms in common, they are not the same.

Essential Criteria for RLS Diagnosis¹²

• Urge to move legs—usually accompanied by uncomfortable leg sensations
• Symptoms begin or worsen during rest, such as when lying or sitting
• Symptoms are partially or totally relieved by movement
• Symptoms are worse in the evening or night

Assessment

The criteria for diagnosis of RLS have been met. A dopamine agonist (DA) is recommended as first-line therapy for RLS.^14† The fact that the patient is taking multiple medications should be taken into consideration when selecting the DA.

MIRAPEX Efficacy in moderate-to-severe Primary RLS

72% of patients on MIRAPEX experienced significant symptom improvements as assessed by physicians²

IMPROVEMENT ON THE CGI-I SCALE*

*Results of a 12-week, placebo-controlled, randomized, double-blind, fixed-dose-treatment trial to assess the efficacy and safety of MIRAPEX vs placebo in the treatment of moderate-to-severe primary RLS. As measured on the Clinical Global Impressions-Improvement (CGI-I) scale, widely accepted for measuring improvement in RLS symptoms on a 7-point scale.

Responders are defined as those having assessments of  "very much improved" or "much improved."

79% of patients who responded to MIRAPEX maintained long-term improvements¹

PROPORTION OF RESPONDERS WHO MAINTAINED RESPONSE ON THE CGI-I AND IRLS SCALES^†

^†After a 26-week, open-label-treatment phase, responders on MIRAPEX were randomized to placebo or continuation of MIRAPEX for an extended 12-week observation period.

Responders are defined as those having assessments of  "very much improved" or "much improved" on the CGI-I and a total International Restless Legs Scale (IRLS) score of 15 or below.

Help Manage Your Patients' Symptoms—With MIRAPEX

• MIRAPEX offers effective, long-term relief from the symptoms of RLS¹
• Well tolerated
• No predicted P450 interactions^‡
• Convenient once-daily dosing
• MIRAPEX Starter Kit offers simple single-step titration^§
  • 75% of patients on the 0.25 mg dose responded to therapy

^†The only approved medications for RLS are in the DA class.
^‡MIRAPEX is not metabolized in the liver and is renally excreted.
^§Provides samples of the first 2 dosage strengths. Additional titration steps may be needed to achieve symptom relief.

Diagnosis

• Restless Legs Syndrome
  • CD-9 Code: 333.94¹⁵

Treatment

• Starter Kit
• Rx MIRAPEX 0.25 mg once daily

Case Study 2