Li Jia, Lou Zhiwei, Liu Xiaoyang, Sun Yajuan, Chen Jiajun
Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Equipment Management, First Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China.
Eur Neurol. 2017;78(3-4):143-153. doi: 10.1159/000479555. Epub 2017 Aug 16.
To assess the efficacy and safety of adjuvant treatment with entacapone in the treatment of later Parkinson's disease (PD) patients with motor fluctuation.
We conducted a systematic review of relevant studies from 8 databases to June 23, 2016.
Fourteen studies were included in this review (n = 2,804). The results showed that compared with placebo, adjuvant therapy with entacapone significantly increased on time (p < 0.01) and reduced off time (p < 0.01), the required levodopa (LD) dose (p < 0.01) and improved Parkinson's Disease Rating Scale (UPDRS) scores (activities of daily living score: p < 0.01; motor score: p < 0.01; UPDRS I-III score: p > 0.05). However, the withdrawal (OR 1.44, 95% CI 1.10-1.89, p < 0.01) due to adverse events and adverse events rates including nausea (OR 2.23, 95% CI 1.56-3.20, p < 0.01), urine discoloration (OR 14.99, 95% CI 7.63-29.44, p < 0.01), gastrointestinal disorder (OR 2.6, 95% CI 1.89-3.57, p < 0.01) and dyskinesia (OR 2.00, 95% CI 1.56-2.58, p < 0.01) increased in patients with entacapone compared with those given a placebo .
This meta-analysis suggests that the entacapone used as adjuvant therapy to LD is effective in the management of later PD with fluctuation. However, patients on entacapone had a higher frequency of adverse events than those on placebo but no occurrence of severe adverse reactions.
评估恩他卡朋辅助治疗晚期帕金森病（PD）伴运动波动患者的疗效和安全性。
我们对截至2016年6月23日来自8个数据库的相关研究进行了系统评价。
本评价纳入了14项研究（n = 2804）。结果显示，与安慰剂相比，恩他卡朋辅助治疗显著增加了“开”期时间（p < 0.01），减少了“关”期时间（p < 0.01）、左旋多巴（LD）所需剂量（p < 0.01），并改善了帕金森病综合评分量表（UPDRS）评分（日常生活活动评分：p < 0.01；运动评分：p < 0.01；UPDRS I - III评分：p > 0.05）。然而，与接受安慰剂治疗的患者相比，恩他卡朋治疗的患者因不良事件导致的撤药率（比值比1.44，95%置信区间1.10 - 1.89，p < 0.01）以及不良事件发生率包括恶心（比值比2.23，95%置信区间1.56 - 3.20，p < 0.01）、尿液变色（比值比14.99，95%置信区间7.63 - 29.44，p < 0.01）、胃肠道紊乱（比值比2.6，95%置信区间1.89 - 3.57，p < 0.01）和异动症（比值比2.00，95%置信区间1.56 - 2.58，p < 0.01）均有所增加。
这项荟萃分析表明，恩他卡朋作为LD的辅助治疗药物，在治疗晚期伴运动波动的PD患者中有效。然而，接受恩他卡朋治疗的患者不良事件发生率高于接受安慰剂治疗的患者，但未发生严重不良反应。
