title: Comparison for Efficacy and Tolerability among Ten Drugs for Treatment of Parkinson's Disease: A Network Meta-Analysis.
abstract: Parkinson's disease (PD) is a long term disorder affects the central nervous system and we aim to determine the relative efficacy of the current available drugs used in PD. Firstly, we performed a systematic review in current literature and eligible studies were retrieved from online databases, relevant data were extracted. Efficacy of these medications was assessed by different Unified Parkinson's Disease Rating Scales (UPDRS). Mean difference (MD) and odds ratio (OR) were produced by pairwise or network meta-analysis (NMA). Finally, we performed a cluster analysis for the included medications with respect to their surface under the cumulative ranking curve (SUCRA). Pairwise meta-analysis suggests that selegiline had a higher ranking in UPDRS II, UPDRS III and UPDRS total than bromocriptine and levodopa. Selegiline was more tolerable than bromocriptine (OR = 0.62, CI: 0.39 to 0.98) and pramipexole was less tolerable than levodopa (OR = 1.43, CI = 1.00 to 2.04). Results of NMA indicate that patients with levodopa, pramipexole, ropinirole and selegiline exhibited a significantly improved UPDRS III than those with lazabemide. To sum up, levodopa, selegiline, ropinirole and rotigotine were recommended for PD patients as they appeared relatively high efficacy and tolerability.
authors.affiliation: Department of Psychological Medicine, Wenzhou Seventh People's Hospital, Wenzhou, 325005, Zhejiang, China.|Institute of Mental Health, Jining Medical University, Jining, 272067, Shandong, China.|Department of Psychological Medicine, Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, 300222, China.|Department of Psychological Medicine, Tianjin Anning Hospital, Tianjin, 300222, China.
authors.forename: Chuanjun
authors.initials: C
authors.lastname: Zhuo
authors.affiliation: Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300075, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Psychological Medicine, Chinese PLA (People's Liberation Army) General Hospital, Beijing, 100853, China.
authors.forename: Ronghuan
authors.initials: R
authors.lastname: Jiang
authors.affiliation: Institute of Mental Health, Jining Medical University, Jining, 272067, Shandong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Ji
authors.affiliation: Department of Psychological Medicine, The Second Affiliated Hospital of Jining Medical College, Jining, 272100, Shandong, China.
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300075, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Xue
authors.affiliation: Department of Neurology, Tianjin Huanhu Hospital, Tianjin Brain Center, Tianjin, 300350, China.
authors.forename: Yuying
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D001971:Bromocriptine / Q000627:therapeutic use; D016000:Cluster Analysis; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007980:Levodopa / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D010848:Picolinic Acids / Q000627:therapeutic use; D000077487:Pramipexole / Q000627:therapeutic use; D012642:Selegiline / Q000627:therapeutic use; D013764:Tetrahydronaphthalenes / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use
chemical_list: D018491:Dopamine Agonists; D007211:Indoles; D010848:Picolinic Acids; D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C046649:ropinirole; D012642:Selegiline; D001971:Bromocriptine; C059303:lazabemide; D007980:Levodopa; D000077487:Pramipexole; C047508:rotigotine