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普拉克索缓释剂治疗帕金森病的疗效与安全性:基于随机对照试验荟萃分析的综述

Efficacy and safety of pramipexole extended-release in Parkinson's disease: a review based on meta-analysis of randomized controlled trials.

作者信息

Shen T, Ye R, Zhang B

机构信息

Department of Neurology, Second Affiliated Hospital of Medical School of Zhejiang University, Hangzhou City, Zhejiang, China.

出版信息

Eur J Neurol. 2017 Jun;24(6):835-843. doi: 10.1111/ene.13303. Epub 2017 May 8.

Abstract

BACKGROUND AND PURPOSE

We performed a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of pramipexole extended-release (pramipexole ER) versus pramipexole immediate-release (pramipexole IR) or placebo in Parkinson's disease.

METHODS

We performed a systematic online search for clinical trials for pramipexole ER treatment up to 1 August 2016. We assessed differences in Unified Parkinson's Disease Rating Scale (UPDRS) scores, percentage of 'on' time or 'off' time, withdrawals, adverse events (AEs) and life quality between pramipexole ER and pramipexole IR or placebo. Data analyses were performed by the Cochrane Collaboration's Review Manager 5.3 software.

RESULTS

Six randomized controlled trials were included. Compared with placebo, pramipexole ER achieved a significant improvement in the UPDRS Part II + III score [weighted mean difference, -4.81; 95% confidence interval (CI), -6.40 to -3.23], whereas no significant difference was found in the UPDRS Part III + III score between pramipexole ER and pramipexole IR groups (weighted mean difference, -0.26; 95% CI, -1.15 to 0.64). No differences were found in total AEs (relative risk, 0.97; 95% CI, 0.92 to 1.03), drug-related AEs (relative risk, 0.97; 95% CI, 0.92 to 1.03) or the commonly reported AEs between pramipexole ER and pramipexole IR.

CONCLUSIONS

Pramipexole ER is as safe and effective as pramipexole IR in the treatment of Parkinson's disease.

摘要

背景与目的

我们进行了一项随机对照试验的荟萃分析,以评估普拉克索缓释剂(pramipexole ER)与普拉克索速释剂(pramipexole IR)或安慰剂相比,在帕金森病治疗中的疗效和安全性。

方法

我们在网上系统检索了截至2016年8月1日的关于普拉克索ER治疗的临床试验。我们评估了普拉克索ER与普拉克索IR或安慰剂在统一帕金森病评定量表(UPDRS)评分、“开”期或“关”期百分比、撤药情况、不良事件(AE)和生活质量方面的差异。数据分析采用Cochrane协作网的Review Manager 5.3软件进行。

结果

纳入了6项随机对照试验。与安慰剂相比,普拉克索ER使UPDRS第II + III部分评分有显著改善[加权平均差,-4.81;95%置信区间(CI),-6.40至-3.23],而普拉克索ER组与普拉克索IR组在UPDRS第III + III部分评分上未发现显著差异(加权平均差,-0.26;95% CI,-1.15至0.64)。在普拉克索ER与普拉克索IR之间,总不良事件(相对风险,0.97;95% CI,0.92至1.03)、药物相关不良事件(相对风险,0.97;95% CI,0.92至1.03)或常见报告的不良事件方面均未发现差异。

结论

在帕金森病治疗中,普拉克索ER与普拉克索IR一样安全有效。

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