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24.08.2019 | Original Article | Ausgabe 1/2020

Neurological Sciences 1/2020

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

Zeitschrift:
Neurological Sciences > Ausgabe 1/2020
Autoren:
De-Qi Jiang, Hua-Kun Wang, Yan Wang, Ming-Xing Li, Li-Lin Jiang, Yong Wang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s10072-019-04050-8) contains supplementary material, which is available to authorized users.

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Abstract

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.

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