Health professionals discussing a new treatment for restless legs syndrome with patients can refer to the latest edition of NPS RADAR for important counselling points. Pramipexole (Sifrol) should be reserved for patients with severe primary cases of restless legs syndrome as the benefits of use are relatively modest, NPS recommends in the latest edition of NPS RADAR. The review of the recently listed PBS item includes an 'information for patients' section to assist with counselling patients.

According to NPS Deputy CEO, Karen Kaye, restless legs can be severe and distressing for some patients who may benefit from drug treatment for their symptoms, but for others the risk of adverse events outweigh the benefits of use.

"Health professionals can suggest non-drug measures for managing restless legs, such as stretching, massage and relaxation techniques. Though these lack strong evidence, patients may benefit from these low risk and low cost interventions," Ms Kaye said.

"If treatment with pramipexole is an option, it's important that patients are aware of the possible side effects as well as the potential benefits."

Pramipexole is not well tolerated by some patients. Sudden-onset daytime sleep (sleep attacks) can occur with pramipexole use and rare cases of compulsive behaviour, such as gambling, have been reported. Nausea and somnolence are common with use of pramipexole but are generally mild and transient.

Evidence for efficacy of pramipexole beyond three months is limited and observations suggest that it declines over time.

NPS RADAR recommends that prescribers diagnose restless legs syndrome by confirming that the patient meets all four clinical criteria and that severity is graded using the International Restless Leg Syndrome Study Group rating scale. Links to the criteria and the rating scale are provided in full review at http://www.npsradar.com.au.

Possible causes of secondary restless legs syndrome should also be considered at the point of diagnosis.

NPS RADAR provides independent information about new medicines and changes to PBS listings important to GPs, pharmacists and other health professionals involved in primary care management of patients.

Source
NPS RADAR