A Sleep Laboratory Study to Investigate the Safety and Efficacy of the Rotigotine Skin Patch in Subjects With Restless Legs Syndrome and End-Stage Renal Disease Requiring Hemodialysis

Inclusion Criteria:

- End-Stage Renal Disease (ESRD) requiring hemodialysis and regular dialysis schedule

- Fulfillment of pre-defined criteria of hematology parameters

- Diagnosis of Restless Legs (RLS) based on the 4 cardinal diagnostic clinical features
according to the International Restless Legs Syndrome Study Group

- Initial response to previous dopaminergic treatment for RLS, or has had no previous
dopaminergic treatment (ie, de novo)

- Score of ≥ 15 points on the IRLS (indicating moderate to severe RLS) at Baseline

- Score of ≥ 11 points on the RLS-DI (Diagnostic Index) at Baseline

- Score of ≥ 4 points on the Clinical Global Impressions (CGI) Item 1 assessment
(indicating moderately ill) at Baseline

- Scores ≥ 15 Periodic Limb Movements (PLMs) per hour on the Periodic Limb Movement
Index (PLMI) based on Polysomnography (PSG) (recorded during the second night) as
assessed by the investigator at Baseline

Exclusion Criteria:

- Clinically relevant Polyneuropathy or Varicosis which cannot be clearly
differentiated from RLS symptoms in the opinion of the investigator

- Clinically relevant concomitant diseases, such as Attention Deficit Hyperactivity
Disorder, Painful Legs, and Moving Toes

- Other central nervous system diseases

- Evidence of an impulse control disorder according to the modified Minnesota Impulsive
Disorders Interview (mMIDI)

- Lifetime history of suicide attempt (including an active attempt, interrupted
attempt, or aborted attempt), or has suicidal ideation in the past 6 months as
indicated by a positive response ('yes') to either Question 4 or Question 5 of the
Columbia-Suicidality Severity Rating Scale (C-SSRS) at Screening (Visit 1) or
Baseline (Visit 2)

- Prior history of psychotic episodes

- History of symptomatic (not asymptomatic) Orthostatic Hypotension

- Clinically relevant Cardiovascular Disease

- Clinically relevant Venous or Arterial Peripheral Vascular Disease

- Malignant Neoplastic Disease requiring therapy within 12 months prior to Screening
(Visit 1)

- Treatment with any of the following drug classes: neuroleptics, norepinephrine and
dopamine reuptake inhibitors (bupropion), gabapentin, budipine, dopamine antagonist
antiemetics (except domperidone), opioids, monoamine oxidase (MAO) inhibitors,
catechol‑O‑methyltransferase (COMT) inhibitors, or psychostimulants (eg,
amphetamines)

- Subject is pregnant, nursing, or is a woman of childbearing potential who is not
surgically sterile, 2 years postmenopausal, or does not consistently use 2 combined
effective methods of contraception (including at least 1 barrier method), unless
sexually abstinent

- Previous treatment with dopamine agonists within a period of 14 days prior to
Baseline (Visit 2), or L-dopa within 7 days prior to Baseline (Visit 2)

- Medical history indicating intolerability to dopaminergic therapy (if pretreated) or
has experienced Augmentation (Garcia-Borreguero and Williams, 2010) when previously
treated with any dopaminergic agent

- Subject has received previous treatment with Rotigotine

- Known hypersensitivity to any of the components of the study medication, such as a
history of significant Skin Hypersensitivity to adhesives, known Hypersensitivity to
other transdermal medications, or unresolved Contact Dermatitis