罗哌尼罗
普拉克索
藤架
左旋多巴
运动障碍
溴隐亭
医学
帕金森病
多巴胺激动剂
不利影响
苄丝肼
恩他卡彭
内科学
麻醉
多巴胺
疾病
多巴胺能
催乳素
激素
作者
Qian Zhang,Xiang‐Ting Chen,Feifei Chen,Si‐Yuan Wen,Changqing Zhou
标识
DOI:10.1016/j.ejphar.2023.175884
摘要
Compared with levodopa, dopamine agonists (DAs) as initial treatment are associated with lower incidences of motor complications in early Parkinson's disease (PD). There is no strong evidence that a given DA is more potent in lower incidences of motor complications than another.We performed a network meta-analysis of levodopa versus DAs as monotherapy in early PD to access the risk of motor complications.Databases were searched up to June 2022 for eligible RCTs. Levodopa and four DAs (pramipexole, ropinirole, bromocriptine and pergolide) were investigated. The incidences of motor complications and efficacy, tolerability and safety outcomes were analyzed.Nine RCTs (2112 patients) were included in the current study. The surface under the cumulative ranking curve (SUCRA) indicated that levodopa ranked first in the incidence of dyskinesia (0.988), followed by pergolide, pramipexole, ropinirole, and bromocriptine (0.704, 0.408, 0.240, 0.160). Pramipexole was least prone to wearing-off (0.109) and on-off fluctuation (0.041). Levodopa performed best in improvements of UPDRS-II, UPDRS-III, and UPDRS-II + III (0.925, 0.952, 0.934). Bromocriptine ranked first in total withdrawals and withdrawals due to adverse events (0.736, 0.751). Four DAs showed different adverse events profiles.In the two non-ergot DAs, ropinirole is associated with a lower risk of dyskinesia while pramipexole is associated with lower risks of wearing-off and on-off fluctuations. Our research may facilitate head-to-head research, larger sample sizes, long following-up time RCTs to confirm the findings of this network meta-analysis.
科研通智能强力驱动
Strongly Powered by AbleSci AI