Nogueira Luis O S, Mazetto Roberto A S V, Defante Maria L R, Antunes Vânio L J, Gonçalves Ocílio Ribeiro, Corso Angela Maria Sandini, Coletta Marcus V Della, Boone Dayany Leonel, Machado Filho Walderico Silva, Borges Vanderci, Ferraz Henrique Ballalai
Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde, Departamento de Medicina, Manaus AM, Brazil.
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre RS, Brazil.
Arq Neuropsiquiatr. 2025 Apr;83(4):1-10. doi: 10.1055/s-0045-1806824. Epub 2025 Apr 27.
Recent research on Parkinson's disease (PD) therapy has highlighted glucagon-like peptide 1 (GLP-1) agonists as potential therapeutic agents. However, recent randomized controlled trials (RCTs) have shown mixed results regarding the use of this medication.
To perform a meta-analysis comparing GLP-1 agonists with placebo or standard PD treatment in adult PD patients.
We systematically searched the PubMed, Embase and Cochrane Central databases. The efficacy outcomes were assessed through the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39). We also assessed adverse events. Dichotomous data were compared using the risk ratio (RR), and continuous endpoints were pooled using the mean difference (MD).
We included 4 RCTs, with a total of 514 patients. In every study, the Hoehn and Yahr stage was < 3. The pooled analysis demonstrated that the use of GLP-1 agonists was not associated with an improvement in the scores on parts I, II, III, and IV of the MDS-UPDRS at 6 and 12 months of follow-up. Neither did quality of life (PDQ-39) show significant differences among the groups, and a higher risk of gastrointestinal adverse events and weight loss was observed with the use of GLP-1 agonists. A subgroup analysis further confirmed the lack of clinical benefits of the intervention regarding all of these efficacy outcomes, and the intervention also significantly reduced result heterogeneity.
In 1 year, GLP-1 agonists failed to improve motor and non-motor features of PD. Additional high-quality studies are needed to draw more robust conclusions about this treatment.
近期关于帕金森病（PD）治疗的研究强调胰高血糖素样肽1（GLP-1）激动剂作为潜在治疗药物。然而，最近的随机对照试验（RCT）显示该药物的使用结果不一。
进行一项荟萃分析，比较GLP-1激动剂与安慰剂或标准PD治疗在成年PD患者中的疗效。
我们系统检索了PubMed、Embase和Cochrane Central数据库。通过运动障碍协会统一帕金森病评定量表（MDS-UPDRS）和39项帕金森病问卷（PDQ-39）评估疗效结果。我们还评估了不良事件。二分数据使用风险比（RR）进行比较，连续终点使用平均差（MD）进行汇总。
我们纳入了4项RCT，共514例患者。每项研究中，Hoehn和Yahr分期均<3期。汇总分析表明，在随访6个月和12个月时，使用GLP-1激动剂与MDS-UPDRS第一、二、三、四部分的评分改善无关。各治疗组间生活质量（PDQ-39）也无显著差异，且使用GLP-1激动剂时胃肠道不良事件和体重减轻的风险更高。亚组分析进一步证实了该干预措施在所有这些疗效指标方面均缺乏临床益处，且该干预措施还显著降低了结果异质性。
在1年时间内，GLP-1激动剂未能改善PD的运动和非运动特征。需要更多高质量研究才能得出关于该治疗更可靠的结论。
