Monday, October 28 Movement disorders 1 SC 201 Slower progression of Parkinson’s disease in patients treated with ropinirole compared with L-dopa: REAL-PET – a randomised controlled 18F-dopa PET study A. L. Whone 1 , R. L. Watts 2 , A. J. Stoessl 3 , P. Remy 4 , M. Ribeiro 5 , O. Rascol 6 , W. Poewe 7 , D . J . Brooks 1 1 Imperial College, London, UNITED KINGDOM, 2 Emory University, Atlanta, GA, USA, 3 University of British Columbia, Vancouver, BC, CANADA, 4 CEA-CNRS URA 2210, Orsay, FRANCE, 5 Commissariat à l’Energie Atomique, Orsay, FRANCE, 6 University Hospital, Toulouse, FRANCE, 7 University of Innsbruck, Innsbruck, AUSTRIA Introduction A 2-year, double-blind, multicentre study was conducted to compare rates of loss of putamen dopamine termi- nal function in patients with early PD treated with ropinirole or L-dopa. Methods The primary endpoint was change in putamen 18 F- dopa uptake (Ki) measured using positron emission tomogra- phy. Data were transformed into standard stereotactic space and analysed with a standard region-of-interest template and statis- tical parametric mapping. Dyskinesias were defined as a score of at least 1 on item 32 of the Unified PD Rating Scale or their report as an adverse event. Results 93 patients were randomised to each group; 73% of the ropinirole and 74% of the L-dopa group completed the study. Loss of putamen Ki was significantly less with ropinirole (–13%) than L-dopa (–20%; p = 0.022). Nigral dopamine sto- rage deteriorated with L-dopa but not ropinirole. The mean treatment difference at baseline was greater for the more affec- ted side (9.4 [95%CI 2.4 –16.4]) compared with the less affec- ted side (4.3 [95%CI 1.9–10.5]). Fewer patients in the ropini- role group developed dyskinesias compared with the L-dopa group (3/92 and 23/91 of patients, respectively; p=0.0002). Within the L-dopa group there was no significant difference in median loss of putamen Ki for patients with dyskinesias (–23.3%, n=19) compared with those without (–18.5%, n= 40; p=0.52). Conclusion The loss of dopamine terminal storage capacity (a measure of disease progression) was 30% slower in patients with early PD taking ropinirole compared with those taking L-dopa. Additionally, use of L-dopa was associated with a 10-fold higher incidence of dyskinesias. SC 202 Pramipexole versus Levodopa in the CALM-PD CIT study: Effects on Parkinson’s disease progression assessed by dopamine transporter imaging Parkinson Study Group Presented by Kenneth Marek New Haven, CT, USA Introduction Dopamine transporter imaging with [123I]b-CIT was used to compare the nigrostriatal dopaminergic degenera- tion after initial treatment with pramipexole or levodopa in early PD. Methods Patients (N=82) in the CALM-PD study (JAMA 2000; 284:1931–1938), underwent 4 scans during a 46-month period. Participants were recruited at 17 centres in North America. The primary outcome variable was the percent change 6th EFNS Congress, Vienna, 2002 26 © 2002 EFNS European Journal of Neurology 9 (Suppl. 2), 12–52