STUDY OBJECTIVES Restless Legs Syndrome (RLS) is a sensory-motor neurological disorder. Low dose opioid medications are prescribed for treatment-refractory RLS. We describe baseline and 1-year longitudinal dosing and symptom outcomes for the National RLS Opioid Registry. METHODS Individuals currently taking a prescribed opioid for diagnosed RLS are included in the registry. Information on initial and current opioid dosages, side effects, past and current concomitant RLS treatments, RLS severity, psychiatric history, and opioid abuse risk factors was collected at baseline. Follow-up online surveys were performed at 6 months and 1-year. RESULTS Participants (n=500) are primarily white, elderly, educated, and retired. Half of all subjects are on opioid monotherapy. Nearly 50% of all subjects are taking methadone, and one-quarter are taking oxycodone formulations. The median total daily opioid dose is 30.0 MME. At baseline, three-quarters of registry participants had been taking a prescribed opioid for RLS for more than one year and one-third for more than five years, and had mild-moderate RLS symptoms. At 1-year follow-up, 31.2% increased dose (median=10 MME) and 16.0% decreased dose of their opioid. An MME increase ≥25 was associated with: opioid use for non-RLS pain, <1 year of opioid use, opioid switch to methadone, and discontinuation of non-opioid RLS medications which, combined, accounted for 91.7% of those with 1-year follow-up increases ≥25 MME. CONCLUSIONS In refractory RLS, prescribed opioids are generally used at low doses with good efficacy. Longitudinally over one year, roughly one-third of participants increased their prescribed opioid dose, though generally by small amounts, with larger dose increases accounted for by predictable features.

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来自国家不宁腿综合征阿片类药物登记处的基线和一年纵向数据

研究目标 不安腿综合征 (RLS) 是一种感觉运动神经系统疾病。低剂量阿片类药物用于治疗难治性 RLS。我们描述了国家 RLS 阿片类药物登记处的基线和 1 年纵向剂量和症状结果。方法 目前服用处方阿片类药物以诊断 RLS 的个人被纳入登记册。在基线收集有关初始和当前阿片类药物剂量、副作用、过去和当前伴随 RLS 治疗、RLS 严重程度、精神病史和阿片类药物滥用风险因素的信息。在 6 个月和 1 年时进行了后续在线调查。结果 参与者 (n=500) 主要是白人、老年人、受过教育的和退休的。所有受试者中有一半接受阿片类药物单一疗法。近 50% 的受试者正在服用美沙酮，四分之一正在服用羟考酮制剂。每日阿片类药物总剂量中位数为 30.0 MME。在基线时，四分之三的注册参与者服用处方阿片类药物治疗 RLS 一年以上，三分之一服用五年以上，并且有轻度至中度 RLS 症状。在 1 年的随访中，阿片类药物的剂量增加了 31.2%（中位数=10 MME），减少了 16.0%。MME 增加 ≥25 与：使用阿片类药物治疗非 RLS 疼痛、使用阿片类药物 <1 年、阿片类药物改用美沙酮和停用非阿片类 RLS 药物，这些因素加起来占 1-年随访增加≥25 MME。结论 在难治性 RLS 中，处方阿片类药物通常以低剂量使用且疗效良好。纵向超过一年，