Seven trials (n=1,483) met all inclusion criteria. Jadad scores ranged from 3 to 5 (most studies scored 5). HRQoL data quality was considered to be limited in six studies and very limited in one study. Duration of follow-up ranged from 10 to 36 weeks. There was no evidence of publication bias.
Compared with placebo, patients with restless legs syndrome who took NEDAs had significantly improved HRQoL (SMD 0.20, 95% CI 0.10 to 0.30; seven studies); only ropinirole yielded significantly improved HRQoL (SMD 0.14, 95% CI 0.01 to 0.26; four studies).
Similar improvement with NEDAs compared with placebo were observed when trials that used Johns Hopkins restless legs syndrome QoL questionnaire were analysed (WMD 4.72, 95% CI 2.96 to 6.47; five studies). Both ropinirole (WMD 4.39, 95% CI 2.42 to 6.35; four studies) and pramipexole (WMD 6.00, 95% CI 2.11 to 9.89; one study) yielded significantly improved HRQoL when considered separately.
Significant heterogeneity was absent for these comparisons. The conclusions remained robust under sensitivity analysis.