Case Study 2

Joan is a 53-year-old white female with hypertension who is receiving anticoagulant therapy*

Chief Complaint

Patient complains of difficulty falling asleep and fatigue.

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

Medical History

• Deep vein thrombosis 5 years ago; recurrence 2 years ago
• Hypertension diagnosed 2 years ago

Social History

• Librarian
• Married

Current Medications

• warfarin sodium 2 mg once daily
• losartan potassium 50 mg once daily

Physical Exam

• Within normal limits

History of Current Illness

Patient mentions uncomfortable sensations in the lower extremities that begin in the evening. She describes symptoms as tingling, tugging sensations occurring at rest and relieved with movement

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

Patient meets the major diagnostic criteria for RLS. Dopamine agonists (DAs) are the treatment of choice for most patients.^2† The fact that the patient is on multiple medications that are metabolized by the P450 system 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 improvements²

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
  • ICD-9 Code: 333.94¹⁵

Treatment

• Starter Kit
• Rx MIRAPEX 0.25 mg once daily

Case Study 3