Rotigotine transdermal delivery for the treatment of Parkinson's disease

Background: Rotigotine is a non-ergot dopamine agonist that has been developed as a new transdermal formulation, and is indicated for use in early (USA and Europe) and advanced (Europe only) Parkinson's disease (PD). The potential advantages of the rotigotine patch include immediacy of effect onset as intestinal absorption in unneeded, constant drug delivery, and ease of use via application of a once-daily adhesive patch. An interesting element of this profile is constant drug delivery, which may avoid pulsatile dopaminergic stimulation, which has been postulated to be related to the development of motor complications. Objective: To consider the evidence surrounding the profile of rotigotine and, in particular, whether its constant delivery system offers significant benefits to the treatment of early and advanced PD. Methods: Source material was identified using a PubMed search for the term ‘rotigotine’ (up to March 2008). The review focuses only on publications related to the rotigotine indication for PD. Results/conclusion: The rotigotine transdermal patch demonstrates clinical efficacy, alongside a tolerability profile that appears to be well within the range of that observed with other non-ergot dopamine agonists. The once-daily patch formulation may favour compliance but, in similarity with the other theoretical advantages of constant drug delivery (for example reduced emergence of motor complications, improved tolerance to peripheral AEs), requires further detailed study.