Long-acting versus standard non-ergot dopamine agonists in Parkinson's disease: a meta-analysis of randomized controlled trials

CNS Neurosci Ther. 2014 Apr;20(4):368-76. doi: 10.1111/cns.12239. Epub 2014 Mar 3.

Abstract

Aims: To evaluate the efficacy, tolerability, and safety of long-acting versus standard non-ergot dopamine agonists (NEDAs) in Parkinson's disease (PD), we performed a meta-analysis of randomized controlled trials (RCTs).

Materials and methods: The PubMed, EMBASE, Cochrane Library databases, and Web of Knowledge were searched up to November 20th 2013. The pooled weighted mean differences (WMDs) and relative risks (RRs) with 95% confidence intervals (CIs) were calculated.

Results: Eight large-scale RCTs, involving 2402 patients, were included in this meta-analysis. Compared with the standard NEDAs, long-acting NEDAs exhibited similar improvements in Unified Parkinson's Disease Rating Scale activities of daily living (ADL) score (WMD 0.09, 95% CI -0.33 to 0.50), motor score (WMD -0.35, 95% CI -1.60 to 0.90), and "off" time (WMD 0.18, 95% CI -0.14 to 0.50). No differences were found in overall withdrawals (RR 1.11, 95% CI 0.94 to 1.32), withdrawals due to adverse events (RR 1.19, 95% CI 0.91 to 1.56), or the ten commonly reported adverse events between the two formulations.

Conclusions: Our meta-analysis showed long-acting NEDAs were noninferior to standard NEDAs in efficacy, tolerability, and safety in the treatment of PD.

Keywords: Extended release pramipexole; Meta-analysis; Parkinson's disease; Ropinirole prolonged release; Rotigotine transdermal patch.

Publication types

  • Evaluation Study
  • Meta-Analysis

MeSH terms

  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Dopamine Agonists / adverse effects
  • Dopamine Agonists / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Patient Dropouts
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Dopamine Agonists