Albuquerque Matheus Barros de, Nunes Luiz Eduardo Duarte Borges, Oliveira Maldonado João Victor de, Melo Ferreira Diogo Grassano, Margato Mateus Macedo, Rabelo Lúcio Vilar, Valença Marcelo Moraes, Oliveira Cordeiro Lúcia Helena
Department of Medicine, Centro de Ciências Médicas, Faculdade de Medicina do Recife, Universidade Federal de Pernambuco, Recife, Brazil.
Department of Medicine, Centro de Ciências Médicas, Universidade de Brasília, Distrito Federal, Brazil.
Parkinsonism Relat Disord. 2025 Jan;130:107220. doi: 10.1016/j.parkreldis.2024.107220. Epub 2024 Nov 29.
Treatments for Parkinson's disease (PD) focus on symptom reduction through dopaminergic therapies, without clear evidence of disease-modifying effects. Glucagon-like peptide-1 (GLP-1) receptor agonists may reduce neuroinflammation by decreasing microglia activation in PD. Clinical trials suggest these agents have disease-modifying potential in PD.
Evaluate the efficacy of GLP-1 receptor agonists in PD.
PubMed, Embase and Cochrane Library were searched to identify randomized controlled trials (RCTs) of GLP-1 agonists for PD, up to July 2024. The risk of bias was assessed using the RoB-2 tool, and statistical analysis was performed with RevMan 5.4.1 software.
GLP-1 receptor agonists showed a beneficial effect on MDS-UPDRS part III motor scores compared to placebo. Off-medication state, there was a -1.22 point improvement (95%CI -2.46, 0.22; P = 0.05). On-medication state, scores improved by -2.52 points (95%CI -4.02, -1.01; P = 0.001). The global MDS-UPDRS score showed a -3.43-point difference (95%CI -6.48, -0.48; P = 0.02). Cognitive performance, assessed via the Mattis DRS-2, improved by 1.32 points (95%CI 0.16, 2.52; P = 0.03). There were no significant differences in the NMSS (-0,19; 95%IC -3,44, 3,05; P = 0.91), in MADRS (-1,04; 95%IC -2,57, 0,48; P = 0.18), or PDQ-39 (-0,91; 95%IC -2,22, 0,39; P = 0.17).
GLP-1 receptor agonists improved motor and cognitive performance in PD, suggesting potential symptomatic benefits. However, further studies are needed to evaluate their long-term effects and their role in disease modification, especially considering ethnic and disease severity variations.
帕金森病（PD）的治疗主要集中在通过多巴胺能疗法减轻症状，但尚无明确证据表明其具有改变疾病进程的作用。胰高血糖素样肽-1（GLP-1）受体激动剂可能通过减少PD中微胶质细胞的活化来减轻神经炎症。临床试验表明，这些药物在PD中具有改变疾病进程的潜力。
评估GLP-1受体激动剂在PD中的疗效。
检索PubMed、Embase和Cochrane图书馆，以确定截至2024年7月的GLP-1激动剂治疗PD的随机对照试验（RCT）。使用RoB-2工具评估偏倚风险，并使用RevMan 5.4.1软件进行统计分析。
与安慰剂相比，GLP-1受体激动剂对MDS-UPDRS第三部分运动评分有有益影响。在未用药状态下，改善了-1.22分（95%CI -2.46，0.22；P = 0.05）。在用药状态下，评分改善了-2.52分（95%CI -4.02，-1.01；P = 0.001）。MDS-UPDRS全球评分显示差异为-3.43分（95%CI -6.48，-0.48；P = 0.02）。通过马蒂斯DRS-2评估的认知表现改善了1.32分（95%CI 0.16，2.52；P = 0.03）。在NMSS（-0.19；95%IC -3.44，3.05；P = 0.91）、MADRS（-1.04；95%IC -2.57，0.48；P = 0.18）或PDQ-39（-0.91；95%IC -2.22，0.39；P = 0.17）方面无显著差异。
GLP-1受体激动剂改善了PD患者的运动和认知表现，提示可能具有对症益处。然而，需要进一步研究来评估其长期效果及其在疾病修饰中的作用，特别是考虑到种族和疾病严重程度的差异。
