Rasagiline combined with levodopa therapy versus levodopa monotherapy for patients with Parkinson's disease: a systematic review

被引:14
作者
Jiang, De-Qi [1 ]
Wang, Hua-Kun [1 ]
Wang, Yan [2 ]
Li, Ming-Xing [3 ]
Jiang, Li-Lin [1 ]
Wang, Yong [4 ]
机构
[1] Yulin Normal Univ, Dept Biol,Guangxi Key Lab Agr Resources Chem, Pharm,Biotechnol, Jiaoyudong Rd . 1303, Yuzhou Dist, Yulin, Guangxi Zhuang, Peoples R China
[2] Guangdong Prov Hosp Integrated Tradit Chinese, Dept Pharm, w Med, Foshan, Peoples R China
[3] Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Dept Pharm, Hangzhou, Peoples R China
[4] Zhujiang Hosp So Med Univ, Dept Pharm, Guangzhou, Peoples R China
关键词
Rasagiline; Levodopa; Parkinson's disease; Motor; Off-time; Systematic review; RANDOMIZED CLINICAL-TRIALS; MAO-B INHIBITOR; DOUBLE-BLIND; ADJUNCT THERAPY; MOTOR FLUCTUATIONS; EFFICACY; MITOCHONDRIAL; SYMPTOMS; NEUROPROTECTION; AGONIST;
D O I
10.1007/s10072-019-04050-8
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective The aim of this report was to systematically evaluate the efficacy and safety of rasagiline (R) plus levodopa (l) (R + l) for the treatment of Parkinson's disease (PD) compared with that of l monotherapy, in order to provide a reference resource for rational drug use. Methods Randomized controlled trials (RCTs) of R + l for PD published up to September 2018 were searched. Sensitivity analyses were also performed. Results Fourteen RCTs with 2531 participants were included. Compared with l monotherapy, the pooled effects of R + l combination therapy on unified Parkinson's disease rating scale (UPDRS) score were (SMD - 0.50, 95% CI - 0.70 to - 0.30, P < 0.00001) for UPDRS motor score, (SMD - 0.59, 95% CI - 0.79 to - 0.39, P < 0.00001) for UPDRS activities of daily living (ADL) score, (SMD - 0.65, 95% CI - 0.81 to - 0.49, P < 0.00001) for UPDRS total score. R + l combination therapy was better than l monotherapy in reducing daily off-time (SMD - 1.15, 95% CI - 2.13 to - 0.17, P = 0.02), but there was a statistically nonsignificant result in daily on-time increase (SMD 1.39, 95% CI - 0.69 to 3.48, P = 0.19). There were no statistical differences in number of adverse events (OR 1.33, 95% CI 0.97 to 1.82, P = 0.07) and number of dropout (OR 0.88, 95% CI 0.65 to 1.19, P = 0.39) between R + l combination therapy and l monotherapy. Conclusions R + l combination therapy was superior to l monotherapy for improvement of UPDRS scores and off-time in PD patients. Moreover, R + l combination therapy and l monotherapy were similar in terms of safety and tolerability.
引用
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页码:101 / 109
页数:9
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