Meta-analysis of the efficacy and safety of long-acting non-ergot dopamine agonists in Parkinson's disease.
A meta-analysis of randomized controlled trials (RCT) was performed to evaluate the efficacy and safety of long-acting non-ergot dopamine agonists (NEDA) versus placebo in Parkinson's disease (PD). A comprehensive literature search up to February 2013 was performed, and the weighted mean differences (WMD) and relative risks (RR) with 95% confidence intervals (CI) were calculated. Nine RCT (n=2857) which assessed the rotigotine transdermal patch, extended-release pramipexole, and ropinirole prolonged-release, were included. Compared with placebo, long-acting NEDA achieved greater improvements in Unified Parkinson's Disease Rating Scale activities of daily living (ADL) score (WMD -1.77, 95% CI -2.13 to -1.41), motor score (WMD -4.18, 95% CI -4.94 to -3.43) and the ADL and motor subtotal score (WMD -5.12, 95% CI -6.16 to -4.07), as well as a reduction in "off" time (WMD -1.29, 95% CI -1.64 to -0.93) and an increase in "on" time without troublesome dyskinesia (WMD 1.55, 95% CI 1.06 to 2.04). Compared with placebo, long-acting NEDA were associated with a higher risk of nausea, but no difference was found in headache incidence. Higher risks of dizziness, somnolence, constipation, vomiting, and insomnia were only found in early PD while higher risks of dyskinesia and hallucination were only found in advanced PD. The results of our meta-analysis showed that the use of long-acting NEDA can reduce the symptoms of PD patients. However, long-acting NEDA were also associated with a higher incidence of adverse events, especially in early PD patients, compared with placebo.
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing 400016, China.
Chang-Qing
CQ
Zhou
Department of Neurology, Yong Chuan Hospital Chongqing Medical University, Chongqing, China.
Jiang-Wei
JW
Zhang
Department of Gynaecology and Obstetrics, Qijiang District Hospital of Chinese Medicine, Chongqing, China.
Min
M
Wang
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuzhong District, Chongqing 400016, China. Electronic address: penwan233@sina.com.
Guo-Guang
GG
Peng
D000978:Antiparkinson Agents / Q000627:therapeutic use*; D052160:Benzothiazoles / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use*; D016503:Drug Delivery Systems; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy*; D000077487:Pramipexole; D016032:Randomized Controlled Trials as Topic; D018709:Statistics, Nonparametric
D000978:Antiparkinson Agents; D052160:Benzothiazoles; D018491:Dopamine Agonists; D007211:Indoles; C046649:ropinirole; D000077487:Pramipexole
Extended-release pramipexole; Meta-analysis; Parkinson’s disease; Ropinirole prolonged-release; Rotigotine transdermal patch