Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/10138 |
Resumo: | Introduction: Restless legs syndrome (RLS) is common and often misdiagnosed entity in the general population and it may be more common in dialysis patients, with an estimated prevalence of 6.6% to 21.5%. Objective: The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. Method: This was a systematic review of randomized or quasirandomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively and adverse events associated with these treatments. Results: Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement (PLM) during time asleep (PLM) in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Conclusion: Only a few therapeutic trials on uremic patients with RLS have been published, and there is not enough to give scientific evidence favoring any specific therapeutic regimen for uremic-associated RLS. Therapy with levodopa, dopaminergics agonists, anticonvulsants, and clonidine tend to be effective, but more studies are need. Key words: systematic review, restless legs syndrome, uremic, end-stage renal disease. |
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Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão SistemáticaThe Pharmacological Treatment for Secondary Restless Legs SyndromeEvidênciasTratamentoSíndrome das Pernas Inquietas SecundáriaIntroduction: Restless legs syndrome (RLS) is common and often misdiagnosed entity in the general population and it may be more common in dialysis patients, with an estimated prevalence of 6.6% to 21.5%. Objective: The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. Method: This was a systematic review of randomized or quasirandomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively and adverse events associated with these treatments. Results: Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement (PLM) during time asleep (PLM) in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Conclusion: Only a few therapeutic trials on uremic patients with RLS have been published, and there is not enough to give scientific evidence favoring any specific therapeutic regimen for uremic-associated RLS. Therapy with levodopa, dopaminergics agonists, anticonvulsants, and clonidine tend to be effective, but more studies are need. Key words: systematic review, restless legs syndrome, uremic, end-stage renal disease.Introdução: A síndrome das pernas inquietas (SPI) é um transtorno comum e geralmente mal-diagnosticada na população e provavelmente mais frequente nos pacientes submetidos à diálise, com uma predominância estimada de 6,6% a 21,5%. Objetivo: O tratamento para SPI urêmica é controverso e consequentemente uma revisão sistemática é necessária para avaliar evidências sobre a efetividade e a segurança dos tratamentos para SPI urêmica. Método: Revisão sistemática de ensaios clínicos randomizados duplo-cegos ou quasirandomizados de tratamentos para SPI urêmica. Os desfechos avaliados foram: alívio dos sintomas da SPI marcados em uma escala validada, qualidade subjetiva do sono, qualidade do sono medidas pela polissonografia e ou actigrafia, medida subjetiva da qualidade de vida e eventos adversos associados com estes tratamentos. Resultados: Seis ensaios clínicos elegíveis foram incluídos. Os resultados das análises subjetivas nestes estudos foram divergentes, embora as análises objetivas em uma experimentação mostrassem que houve uma melhora estatisticamente significante nos movimentos periódicos dos membros (PLMS) durante o tempo de sono no grupo tratamento. Nenhuma análise combinada (metanálise) foi executada. Os eventos adversos mais comuns observados foram sintomas gastrintestinais. Conclusão: Somente alguns ensaios clínicos para o tratamento dos pacientes com SPI urêmica foram publicados e não são suficientes para fornecerem provas científicas que favoreçam algum regime terapêutico. Terapia com levodopa, agonistas dopaminérgicos, anticonvulsivantes e clonidina tendem a ser efetivas, porém mais estudos são necessários. Palavras-chave: revisão sistemática, síndrome das pernas inquietas, urêmico, doença renal em estágio terminal.TEDEUniversidade Federal de São Paulo (UNIFESP)Prado, Gilmar Fernandes do [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Oliveira, Márcio Moysés de [UNIFESP]2015-07-22T20:50:53Z2015-07-22T20:50:53Z2009-04-29info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersionapplication/pdfOLIVEIRA, Márcio Moysés de. Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática. 2009. Tese (Doutorado) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2009.Publico-00367.pdfhttp://repositorio.unifesp.br/handle/11600/10138porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-05T10:47:26Zoai:repositorio.unifesp.br/:11600/10138Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-05T10:47:26Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática The Pharmacological Treatment for Secondary Restless Legs Syndrome |
title |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática |
spellingShingle |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática Oliveira, Márcio Moysés de [UNIFESP] Evidências Tratamento Síndrome das Pernas Inquietas Secundária |
title_short |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática |
title_full |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática |
title_fullStr |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática |
title_full_unstemmed |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática |
title_sort |
Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática |
author |
Oliveira, Márcio Moysés de [UNIFESP] |
author_facet |
Oliveira, Márcio Moysés de [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Prado, Gilmar Fernandes do [UNIFESP] Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Oliveira, Márcio Moysés de [UNIFESP] |
dc.subject.por.fl_str_mv |
Evidências Tratamento Síndrome das Pernas Inquietas Secundária |
topic |
Evidências Tratamento Síndrome das Pernas Inquietas Secundária |
description |
Introduction: Restless legs syndrome (RLS) is common and often misdiagnosed entity in the general population and it may be more common in dialysis patients, with an estimated prevalence of 6.6% to 21.5%. Objective: The treatment for uremic RLS has been controversial and therefore a systematic synthesis of the evidence is needed in order to evaluate the effectiveness and safety of treatments for uremic RLS. Method: This was a systematic review of randomized or quasirandomized double-blind trials on treatments for uremic RLS. The outcomes considered were relief of RLS symptoms marked on a validated scale, subjective sleep quality, sleep quality measured using night polysomnography and actigraphy, quality of life measured subjectively and adverse events associated with these treatments. Results: Six eligible clinical trials were included. The results from subjective analyses in these studies were divergent, although objective analyses in one trial showed that there was a statistically significant improvement in periodic leg movement (PLM) during time asleep (PLM) in the treatment group. No combined analysis (meta-analysis) was performed. The most common adverse event seen was gastrointestinal symptoms. Conclusion: Only a few therapeutic trials on uremic patients with RLS have been published, and there is not enough to give scientific evidence favoring any specific therapeutic regimen for uremic-associated RLS. Therapy with levodopa, dopaminergics agonists, anticonvulsants, and clonidine tend to be effective, but more studies are need. Key words: systematic review, restless legs syndrome, uremic, end-stage renal disease. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009-04-29 2015-07-22T20:50:53Z 2015-07-22T20:50:53Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
OLIVEIRA, Márcio Moysés de. Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática. 2009. Tese (Doutorado) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2009. Publico-00367.pdf http://repositorio.unifesp.br/handle/11600/10138 |
identifier_str_mv |
OLIVEIRA, Márcio Moysés de. Tratamento Farmacológico da Síndrome das Pernas Inquietas Secundária: Revisão Sistemática. 2009. Tese (Doutorado) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2009. Publico-00367.pdf |
url |
http://repositorio.unifesp.br/handle/11600/10138 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
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reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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