A systematic review and mixed treatment comparison of monotherapy in early Parkinson's disease: implications for Latin America

Expert Rev Pharmacoecon Outcomes Res. 2016;16(1):97-102. doi: 10.1586/14737167.2016.1135740. Epub 2016 Jan 25.

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.

Keywords: Parkinson’s disease; indirect comparisons; random-effects model; randomized controlled trials; treatment.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Antiparkinson Agents / administration & dosage*
  • Antiparkinson Agents / therapeutic use
  • Drug Therapy, Combination
  • Humans
  • Latin America
  • Models, Statistical*
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Antiparkinson Agents