title: A systematic review and mixed treatment comparison of monotherapy in early Parkinson's disease: implications for Latin America.
abstract: Parkinson's disease (PD) is the second most common neurodegenerative disease. There are no clinical trials comparing all available pharmacological therapies for the treatment of early PD. The objective of this review is to indirectly analyze the efficacy of antiparkinson drugs currently available in Latin America. A systematic review was performed exploring only placebo-controlled randomized trials comparing antiparkinson monotherapy (levodopa, pramipexole, rasagiline, or selegiline) in patients with PD on Hoehn and Yahr stages I through III published from January 1994 to May 2014. The primary outcome was the mean change in the Unified PD Rating Scale (UPDRS) I, II and III. A mixed treatment comparison analysis (indirect comparisons) through a random-effects model was performed. Levodopa demonstrated the highest effects in terms of UPDRS score improvement both from baseline and when compared to other treatments. Levodopa showed a 60.1% probability of granting the greatest reduction in UPDRS I, II and III.
authors.affiliation: a Universidad Autónoma Metropolitana, Unidad Xochimilco , Mexico City , Mexico.
authors.forename: Maribel
authors.initials: M
authors.lastname: Márquez-Cruz
authors.affiliation: b McMaster University , Ontario , Canada.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Díaz-Martínez
authors.affiliation: a Universidad Autónoma Metropolitana, Unidad Xochimilco , Mexico City , Mexico.
authors.forename: Herman
authors.initials: H
authors.lastname: Soto-Molina
authors.affiliation: c Clinical Neurodegenerative Research Unit , National Institute of Neurology and Neurosurgery , Mexico City , Mexico.
authors.forename: Adib Jorge
authors.initials: AJ
authors.lastname: De Saráchaga
authors.affiliation: c Clinical Neurodegenerative Research Unit , National Institute of Neurology and Neurosurgery , Mexico City , Mexico.
authors.forename: Amin
authors.initials: A
authors.lastname: Cervantes-Arriaga
authors.affiliation: c Clinical Neurodegenerative Research Unit , National Institute of Neurology and Neurosurgery , Mexico City , Mexico.|d Movement Disorder Clinic , National Institute of Neurology and Neurosurgery , Mexico City , Mexico.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Llorens-Arenas
authors.affiliation: c Clinical Neurodegenerative Research Unit , National Institute of Neurology and Neurosurgery , Mexico City , Mexico.|d Movement Disorder Clinic , National Institute of Neurology and Neurosurgery , Mexico City , Mexico.
authors.forename: Mayela
authors.initials: M
authors.lastname: Rodríguez-Violante
mesh_terms: D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007843:Latin America; D015233:Models, Statistical; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents
keywords: Parkinson’s disease; indirect comparisons; random-effects model; randomized controlled trials; treatment