Case Study 3

Bill is a 48-year-old white male with high cholesterol, hypertension, erectile dysfunction, and RLS. He has scheduled a visit to discuss his RLS treatment*

Chief Complaint

Patient is now able to sleep, but still experiencing discomfort in his legs at night and also reports trouble relaxing.

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

Medical History

• Familial hypercholesterolemia diagnosed 6 years ago
• Hypertension diagnosed 3 years ago
• Erectile dysfunction diagnosed 2 years ago
• RLS diagnosed 1 month ago

Social History

• Financial planner
• Married with young child

Current Medications

• atorvastatin calcium 40 mg once daily
• losartan potassium 50 mg once daily
• sildenafil citrate 50 mg prn
• clonazepam 1 mg qhs

Physical Exam

• Within normal limits

History of Current Illness

A diagnosis of RLS is confirmed and, in probing the patient, drowsiness and poor concentration are also noted

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

Recommendations for the Pharmacological Treatment of RLS

Dopamine agonists (DAs) are the treatment of choice for most patients with RLS who require daily treatment^14†

Assessment

Patient's continued uncomfortable leg sensations represent RLS symptoms that are not being effectively treated by clonazepam. Clonazepam should be tapered and discontinued. Consider a DA, which is approved and recommended as first-line therapy for RLS. Patient's comorbidities and 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
  • ICD-9 Code: 333.94¹⁵

Treatment

• Starter Kit
• Rx MIRAPEX 0.25 mg once daily

Prescribing MIRAPEX