Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis
Background. Rasagiline is a selective, irreversible monoamine oxidase type B inhibitor used as monotherapy in early Parkinson’s disease and as an adjunct therapy to levodopa in Parkinson’s disease with motor fluctuations. Objectives. This meta-analysis aimed to provide updated evidence on the effica...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2022/4216452 |
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| _version_ | 1832554741297577984 |
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| author | Osamu Kano Hiroshi Tsuda Ayako Hayashi Masaki Arai |
| author_facet | Osamu Kano Hiroshi Tsuda Ayako Hayashi Masaki Arai |
| author_sort | Osamu Kano |
| collection | DOAJ |
| description | Background. Rasagiline is a selective, irreversible monoamine oxidase type B inhibitor used as monotherapy in early Parkinson’s disease and as an adjunct therapy to levodopa in Parkinson’s disease with motor fluctuations. Objectives. This meta-analysis aimed to provide updated evidence on the efficacy for motor and nonmotor symptoms and the safety of rasagiline/levodopa versus levodopa in patients with Parkinson’s disease experiencing motor fluctuations. Methods. A systematic literature search was conducted (January 18-19, 2021) using PubMed, Cochrane Library, EMBASE, Web of Science, and Google Scholar to identify randomized controlled trials comparing rasagiline/levodopa versus placebo/levodopa in patients with Parkinson’s disease experiencing motor fluctuations. Outcomes included change in wearing-off time, Unified Parkinson’s Disease Rating Scale (UPDRS)/Movement Disorder Society-UPDRS (MDS-UPDRS) II and III scores, treatment-emergent adverse events (TEAEs), and Parkinson’s Disease Questionnaire (PDQ-39) summary index score. A random effect model was used to estimate the treatment effects. Results. Six studies were included (1912 patients). Significant improvements in wearing-off time (standardized mean difference [SMD]: −0.50, 95% confidence interval [CI]: –0.92 to –0.09, p=0.002), levodopa dosage (SMD: −0.18, 95% CI: −0.35 to –0.01, p=0.041), UPDRS/MDS-UPDRS II (SMD: −0.39, 95% CI: −0.52 to –0.25, p<0.0001), UPDRS/MDS-UPDRS III (SMD: −0.30, 95% CI: −0.44 to –0.16, p<0.0001), and PDQ-39 summary index score (SMD: –0.21, 95% CI: –0.37 to –0.04, p=0.013) were observed with rasagiline/levodopa versus placebo/levodopa. The incidence of TEAEs did not differ between treatments (risk ratio: 1.13, 95% CI: 0.98–1.30, p=0.093). Conclusions. This meta-analysis further indicated the superiority of rasagiline/levodopa in improving motor and nonmotor symptoms of Parkinson’s disease, with a similar safety profile to that of levodopa in Parkinson’s disease with motor fluctuations. |
| format | Article |
| id | doaj-art-edbd91f833c24c69b4423b4c408f5bf7 |
| institution | Kabale University |
| issn | 2042-0080 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-edbd91f833c24c69b4423b4c408f5bf72025-02-03T05:50:45ZengWileyParkinson's Disease2042-00802022-01-01202210.1155/2022/4216452Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-AnalysisOsamu Kano0Hiroshi Tsuda1Ayako Hayashi2Masaki Arai3Department of NeurologyDepartment of NeurologyTakeda Pharmaceutical Company LimitedTakeda Pharmaceutical Company LimitedBackground. Rasagiline is a selective, irreversible monoamine oxidase type B inhibitor used as monotherapy in early Parkinson’s disease and as an adjunct therapy to levodopa in Parkinson’s disease with motor fluctuations. Objectives. This meta-analysis aimed to provide updated evidence on the efficacy for motor and nonmotor symptoms and the safety of rasagiline/levodopa versus levodopa in patients with Parkinson’s disease experiencing motor fluctuations. Methods. A systematic literature search was conducted (January 18-19, 2021) using PubMed, Cochrane Library, EMBASE, Web of Science, and Google Scholar to identify randomized controlled trials comparing rasagiline/levodopa versus placebo/levodopa in patients with Parkinson’s disease experiencing motor fluctuations. Outcomes included change in wearing-off time, Unified Parkinson’s Disease Rating Scale (UPDRS)/Movement Disorder Society-UPDRS (MDS-UPDRS) II and III scores, treatment-emergent adverse events (TEAEs), and Parkinson’s Disease Questionnaire (PDQ-39) summary index score. A random effect model was used to estimate the treatment effects. Results. Six studies were included (1912 patients). Significant improvements in wearing-off time (standardized mean difference [SMD]: −0.50, 95% confidence interval [CI]: –0.92 to –0.09, p=0.002), levodopa dosage (SMD: −0.18, 95% CI: −0.35 to –0.01, p=0.041), UPDRS/MDS-UPDRS II (SMD: −0.39, 95% CI: −0.52 to –0.25, p<0.0001), UPDRS/MDS-UPDRS III (SMD: −0.30, 95% CI: −0.44 to –0.16, p<0.0001), and PDQ-39 summary index score (SMD: –0.21, 95% CI: –0.37 to –0.04, p=0.013) were observed with rasagiline/levodopa versus placebo/levodopa. The incidence of TEAEs did not differ between treatments (risk ratio: 1.13, 95% CI: 0.98–1.30, p=0.093). Conclusions. This meta-analysis further indicated the superiority of rasagiline/levodopa in improving motor and nonmotor symptoms of Parkinson’s disease, with a similar safety profile to that of levodopa in Parkinson’s disease with motor fluctuations.http://dx.doi.org/10.1155/2022/4216452 |
| spellingShingle | Osamu Kano Hiroshi Tsuda Ayako Hayashi Masaki Arai Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis Parkinson's Disease |
| title | Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis |
| title_full | Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis |
| title_short | Rasagiline as Adjunct to Levodopa for Treatment of Parkinson’s Disease: A Systematic Review and Meta-Analysis |
| title_sort | rasagiline as adjunct to levodopa for treatment of parkinson s disease a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2022/4216452 |
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