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Italian adaptation of international recommendations for the management of restless legs syndrome: A consensus statement by the scientific committee of RLS-Italia.

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Τίτλος: Italian adaptation of international recommendations for the management of restless legs syndrome: A consensus statement by the scientific committee of RLS-Italia.
Συγγραφείς: Mogavero MP; Oasi Research Institute-IRCCS, Via Conte Ruggero 73, Troina, 94018, Italy., Bruni O; Department of Human Neurosciences, Sapienza University, Rome, Italy., Romigi A; IRCCS Neuromed-Istituto Neurologico Mediterraneo Pozzilli, Pozzilli, Italy.; Departmental Faculty of Medicine, Saint Camillus International University of Health and Medical Sciences UniCamillus, Rome, Italy., Liguori C; Departmental Faculty of Medicine, Saint Camillus International University of Health and Medical Sciences UniCamillus, Rome, Italy.; Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.; Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy., Arnaldi D; Dipartimento di Neuroscienze, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Oftalmologia, Genova, Genetica, Italy.; AOM - IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Guarnieri B; Center of Sleep Medicine, Villa Serena Hospital, Città S. Angelo, Pescara, Italy.; Fondazione Villaserena per la ricerca, Città S. Angelo, Pescara, Italy., Ferri R; Oasi Research Institute-IRCCS, Via Conte Ruggero 73, Troina, 94018, Italy. rferri@oasi.en.it.
Πηγή: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2026 Oct 17; Vol. 47 (11). Date of Electronic Publication: 2026 Oct 17.
Τύπος έκδοσης: Journal Article; Consensus Statement
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 100959175 Publication Model: Electronic Cited Medium: Internet ISSN: 1590-3478 (Electronic) Linking ISSN: 15901874 NLM ISO Abbreviation: Neurol Sci Subsets: MEDLINE
Imprint Name(s): Original Publication: Milano, Italy : Springer-Verlag Italia, c2000-
Ιατρικοί όροι (MeSH): Restless Legs Syndrome*/therapy , Restless Legs Syndrome*/diagnosis , Restless Legs Syndrome*/drug therapy , Practice Guidelines as Topic*/standards , Disease Management*, Dopamine Agonists/therapeutic use ; Humans ; Italy
Περίληψη: Background: Recent international recommendations have substantially changed the management of restless legs syndrome (RLS), emphasizing systematic iron assessment, earlier use of iron therapy and α2δ ligands, and greater caution with chronic dopaminergic treatment because of augmentation. Their implementation requires adaptation to national healthcare organization, regulatory indications, reimbursement, and access to specialist services.
Methods: The Scientific Committee of RLS-Italia conducted a structured, non-Delphi consensus process based on the 2025 American Academy of Sleep Medicine clinical practice guideline and systematic review, the 2026 RLS Foundation algorithm, the World Sleep Society partial endorsement, and selected supporting evidence. Successive drafts were circulated, discussed, and approved by all authors.
Results: The proposed Italian framework prioritizes clinical diagnosis, exclusion of mimics, correction of exacerbating factors, systematic assessment of iron status, and iron treatment when indicated. α2δ ligands are preferred for most adults with chronic persistent RLS, whereas dopamine agonists should be restricted to selected patients and monitored for augmentation. Refractory or augmented disease should be managed by clinicians with specific RLS expertise, with consideration of intravenous iron, opioids, or device-based treatment. Dipyridamole is not included in the standard pathway, and periodic limb movement disorder should not be diagnosed or treated solely on the basis of polysomnographic findings.
Conclusions: This consensus statement provides a nationally coherent framework that can support regional implementation through locally appropriate organizational and clinical protocols.
(© 2026. Fondazione Società Italiana di Neurologia.)
Competing Interests: Declarations. Ethics approval: Ethics approval was not required because this article is a consensus statement and guideline-adaptation document and did not involve human participants, human data, biological material, or animal research. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare that they have no relevant financial interests to disclose. The authors are members of the Scientific Committee of RLS-Italia in the preparation of this consensus document. This role was non-remunerated and is disclosed as a non-financial interest. RLS-Italia supported the initiative but had no role in determining the scientific content of the recommendations, which reflect the collegial discussion and agreement of the Scientific Committee.
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Contributed Indexing: Keywords: Dopamine agonists; Iron therapy; Periodic limb movement disorder; Restless legs syndrome; Treatment guidelines; α2δ ligands
Substance Nomenclature: 0 (Dopamine Agonists)
Entry Date(s): Date Created: 20261018 Date Completed: 20261018 Latest Revision: 20261018
Update Code: 20261018
DOI: 10.1007/s10072-026-09487-2
PMID: 42891733
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1590-3478
DOI:10.1007/s10072-026-09487-2