Effects of MAO‑B Inhibitors in life quality of Parkinson's disease patients: a Systematic Review and Meta‑Analysis

Introduction: Monoamine oxidase-B (MAO-B) inhibitors, as an add-on therapy to levodopa, are widely used in Parkinson's disease (PD). The effects of MAO-B inhibitors on quality of life remain unclear, and the aim of this systematic review and meta-analysis was to assess the efficacy and safety of MAO-B inhibitors on quality of life in different domains.

Methods: We searched PubMed, Embass, and Cochrane Library databases for randomized controlled trials of PD patients who were administered MAO-B inhibitors. Outcomes were the change from baseline in the total score of life quality scales, change from baseline in domains of the Parkinson's Disease Questionnaire-39 (PDQ-39), and incidence of treatment-associated adverse events (TAEs).

Results: Sixteen studies covering 4734 PD patients were included in the study. The PDQ-39 scores were lower with MAO-B inhibitors than with placebo (SMD: -0.26, 95% CI: [-0.49, -0.04], P=0.02). The European Quality of Life Questionnaire-5D (EQ-5D) scores were higher in the MAO-B inhibitor group. Patients treated with MAO-B inhibitors had better performance in the domains of mobility, activities of daily living, emotional well-being, stigma, communication, and bodily discomfort, except for social support and cognition. The incidence of TAEs was slightly higher in patients treated with MAO-B inhibitors.

Conclusions: Evidence has shown that MAO-B inhibitors, especially safinamide, are effective in improving the quality of life of PD patients, although with a slightly higher incidence of TAEs. The domains of quality of life were improved, except for cognition and social support, compared with placebo. Further studies are warranted to evaluate the effects of other MAO-B inhibitors on quality of life.