Clinical Scenario

This protocol addresses adults 18 years of age and older with confirmed restless legs syndrome who do not have end-stage renal disease. This population is eligible for first-line pharmacologic intervention supported by AASM clinical practice recommendations.

Treatment Approach — Partial Overview

First-line management centres on selecting an oral agent from the alpha-2-delta ligand class. Separately, for patients whose iron parameters meet specific thresholds, an intravenous iron formulation may qualify as a first-line option. The complete selection criteria, agent choice, sequencing, and all supporting guidance are available in the full protocol.

References

DOI: 10.5664/jcsm.11390

Recommendations for specific interventions for the treatment of adults with RLS are presented below.
In adults with RLS, the AASM recommends the use of gabapentin enacarbil over no gabapentin enacarbil (strong recommendation, moderate certainty of evidence).
In adults with RLS, the AASM recommends the use of gabapentin over no gabapentin (strong recommendation, moderate certainty of evidence).
In adults with RLS, the AASM recommends the use of pregabalin over no pregabalin (strong recommendation, moderate certainty of evidence).
In adults with RLS, the AASM recommends the use of IV ferric carboxymaltose over no IV ferric carboxymaltose in patients with appropriate iron status (see good practice statement for iron parameters) (strong recommendation, moderate certainty of evidence).

View source ↗

First-Line Treatment of Restless Leg Syndrome in Adults Aged 18 and Older Without End-Stage Renal Disease

Clinical Scenario

Treatment Approach — Partial Overview

Treatment Goals

References