Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medical Research Group of Egypt.
CNS Neurol Disord Drug Targets. 2019;18(4):317-325. doi: 10.2174/1871527318666190314101314.
Levetiracetam, a novel antiepileptic drug, has shown antidyskinetic effects in experimental animal models of Parkinson's disease (PD). The tolerability and efficacy of levetiracetam in reducing the levodopa-induced dyskinesia (LID) in PD patients have not been established. Therefore, this study aims to synthesize evidence from published prospective clinical trials about the efficacy of levetiracetam for the management of LID in PD patients.
We followed the PRISMA statement guidelines during the preparation of this systematic review. A computer literature search of PubMed, EBSCO, Scopus, MEDLINE, and the web of science was carried out. We selected prospective clinical trials assessing the anti-dyskinetic efficacy of levetiracetam for treating LID in patients with PD. The Abnormal Involuntary Movement Scale (AIMS), Clinical Global Impression Score (GCI), UPDRS III, and UPDRS IV were considered as the primary outcome measures; their data were extracted and reviewed.
Our review included seven clinical trials with a total of 150 patients. Of them, three studies were randomized controlled trials, and the remaining were open-label single arm trials. Four studies reported poor tolerability of the levetiracetam with mild anti-dyskinetic effects. Levetiracetam slightly improved the UPDRS-IV and AIMS scores with small effect size. In the remaining three studies, levetiracetam failed to exhibit any anti-dyskinetic effects.
Current evidence does not support the efficacy of the levetiracetam for treating LID in PD patients, however, due to the limited number of published randomized control trials (RCTs), further RCTs are required.
左乙拉西坦是一种新型抗癫痫药物，已在帕金森病（PD）的实验动物模型中显示出抗运动障碍作用。左乙拉西坦减轻 PD 患者左旋多巴诱导的运动障碍（LID）的耐受性和疗效尚未确定。因此，本研究旨在综合已发表的前瞻性临床试验证据，评估左乙拉西坦治疗 PD 患者 LID 的疗效。
我们在准备系统评价时遵循 PRISMA 声明指南。对 PubMed、EBSCO、Scopus、MEDLINE 和 web of science 进行了计算机文献检索。我们选择了评估左乙拉西坦抗 LID 疗效的前瞻性临床试验。异常不自主运动量表（AIMS）、临床总体印象评分（GCI）、UPDRS III 和 UPDRS IV 被认为是主要结局指标；提取和审查了他们的数据。
我们的综述包括 7 项临床试验，共 150 名患者。其中，3 项为随机对照试验，其余为开放标签单臂试验。4 项研究报告了左乙拉西坦的耐受性差，具有轻度抗运动障碍作用。左乙拉西坦略微改善了 UPDRS-IV 和 AIMS 评分，效果较小。在其余 3 项研究中，左乙拉西坦未能表现出任何抗运动障碍作用。
目前的证据不支持左乙拉西坦治疗 PD 患者 LID 的疗效，但是，由于发表的随机对照试验（RCTs）数量有限，需要进一步的 RCTs。
