Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
Present Address: Information Centre, The Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
BMC Neurol. 2022 Aug 25;22(1):320. doi: 10.1186/s12883-022-02830-y.
Quality of life (QoL) in patients with Parkinson's disease (PD) is increasingly used as an efficacy outcome in clinical studies of PD to evaluate the impact of treatment from the patient's perspective. Studies demonstrating the treatment effect of pramipexole on QoL remain inconclusive. This study aims to evaluate the effect of pramipexole on QoL in patients with PD by conducting a systematic review and meta-analysis of existing clinical trials.
A systematic literature search of PubMed, Embase and the Cochrane Library was performed from inception to 30 April 2022 to identify randomised, placebo-controlled trials of patients with idiopathic PD receiving pramipexole, who reported a change from baseline in their QoL as measured by the 39-item Parkinson's Disease Questionnaire (PDQ-39). Risk of bias was independently assessed by two reviewers using the Cochrane Collaboration's tool for bias assessment.
Of 80 eligible articles screened, six trials consisting of at least 2000 patients with early or advanced PD were included. From the synthesis of all six selected trials, a significant mean change from baseline in the PDQ-39 total score of -2.49 (95% CI, -3.43 to -1.54; p < 0.0001) was observed with pramipexole compared with placebo. A trend toward improvement in QoL was consistently observed among patients who received optimal doses of pramipexole (≥ 80% of the study population on 1.5 mg dosage), regardless of disease severity (advanced versus early) or baseline QoL levels.
This meta-analysis provides evidence for the potential treatment benefit of pramipexole in improving QoL in patients with PD.
生活质量（QoL）在帕金森病（PD）患者中越来越多地被用作 PD 临床研究的疗效结果，以从患者角度评估治疗的影响。但仍有研究表明普拉克索对 QoL 的治疗效果尚无定论。本研究旨在通过对现有临床试验进行系统评价和荟萃分析，评估普拉克索对 PD 患者 QoL 的影响。
从建库至 2022 年 4 月 30 日，对 PubMed、Embase 和 Cochrane 图书馆进行系统文献检索，以确定接受普拉克索治疗的特发性 PD 患者的随机、安慰剂对照试验，这些患者报告了使用 39 项帕金森病问卷（PDQ-39）测量的 QoL 从基线的变化。两名审查员使用 Cochrane 协作偏倚评估工具独立评估偏倚风险。
在 80 篇符合条件的文章中，有 6 项试验（至少包括 2000 名早期或晚期 PD 患者）符合纳入标准。从所有 6 项入选试验的综合结果来看，与安慰剂相比，普拉克索组 PDQ-39 总分的平均基线变化为-2.49（95%CI，-3.43 至-1.54；p<0.0001）。普拉克索组（1.5mg 剂量时接受 80%以上研究人群剂量的患者）的 QoL 呈改善趋势，且与疾病严重程度（晚期或早期）或基线 QoL 水平无关。
这项荟萃分析为普拉克索治疗 PD 患者改善 QoL 提供了潜在治疗益处的证据。
