Long-acting versus standard non-ergot dopamine agonists in treatment of Parkinson′s disease: a Meta-analysis of randomized controlled trails

Objective To evaluate the efficacy, tolerability, and safety of long-acting versus standard non-ergot dopamine agonists (NEDAs) in the treatment of Parkinson′s disease by performing a Meta-analysis of randomized controlled trials (RCTs). Methods The PubMed, EMBASE, Cochrane Library databases, and Web of Knowledge were searched up to August 15, 2019. The pooled weighted mean difference (WMD) and relative risk (RR) with 95%CI were calculated. Review Manager software version 5.3 and Stata 12.0 were used to analyze the data. Results Eleven large-scale RCTs, involving 3280 patients, were included in this Meta-analysis. The results of Meta-analysis showed that compared with the standard NEDAs, long-acting NEDAs exhibited similar improvements in UPDRSⅡ score (WMD=-0.15, 95% CI: -0.63-0.33), UPDRSⅢ score (WMD=0.04, 95% CI: -0.24-0.33) and UPDRSⅡ+ Ⅲ score (WMD=0.12, 95% CI: -1.25-1.49); there was no differences in overall withdrawals (RR=1.11, 95% CI: 0.95-1.31), or withdrawals due to adverse events (RR=1.14, 95% CI: 0.90-1.45) between the two formulations; and there was no differences in the risks of adverse events (RR=1.02, 95% CI: 0.97-1.07) and serious adverse event (RR=0.96, 95% CI: 0.73-1.26). Conclusion Our Meta-analysis shows that long-acting NEDAs are similar to standard NEDAs in efficacy, tolerability, and safety in the treatment of Parkinson′s disease. Key words: Parkinson′s disease; Extended release pramipexole; Ropinirole prolonged release; Rotigotine transdermal patch; Systematic review; Non-ergot dopamine agonist