Tang Rong, Zhang Sunying, Sun Rui, Xu Jiacheng, Hu Yunxing, Tan Hongyu, Chen Ling
MA & OR, Organon Research and Development, Organon China, Floor 6, Building A, One ITC, No. 1901 Huashan Road, Xuhui District, Shanghai, 200030, China.
Department of Neurology, Guangdong Sanjiu Brain Hospital, No. 578, Tai Sha Nan Lu, Guangzhou, 510510, Guangdong, China.
Neurol Ther. 2025 May 28. doi: 10.1007/s40120-025-00764-4.
Despite promising results from continuous dopaminergic stimulation (CDS)-based treatments, the effectiveness of sustained-release formulations of levodopa remains debated. This meta-analysis aims to assess the effectiveness of CDS-based levodopa treatment in patients with early to mid-stage Parkinson's disease (PD).
Comprehensive searches were performed using PubMed, EMBASE, the Cochrane Library, Web of Science, and ClinicalTrials.gov. The clinical trials were included to compare CDS-based levodopa treatments with intermittent levodopa (IL) treatment in patients with early to mid-stage PD.
A total of 18 clinical trials involving 2208 patients were included in this meta-analysis. Results showed that CDS-based levodopa treatments were associated with a significant reduction in Unified Parkinson's Disease Rating Scale (UPDRS) II scores (mean difference (MD) - 0.79, 95% CI - 1.26, - 0.32) and UPDRS III scores (MD - 1.03, 95% CI - 1.98, - 0.08) compared to IL treatments. Additionally, CDS-based treatments increased ON time without troublesome dyskinesia (MD 0.63, 95% CI 0.35, 0.91) and decreased OFF time (MD - 0.60, 95% CI - 1.03, - 0.18). In the subgroup analysis of UPDRS II scores and UPDRS III scores, the MD were - 0.62 (95% CI - 1.27, 0.02) and - 1.20 (95% CI - 4.74, 2.34) for 200 mg and - 1.10 (95% CI - 1.88, - 0.32) and - 1.25 (95% CI - 3.26, 0.76) for a combination of levodopa and other drugs at varying dosages, respectively.
Treatment with CDS-based levodopa offers significant benefits in managing motor symptoms and reducing complications in patients with early to mid-stage PD. These therapies provide a promising alternative to traditional IL treatments, potentially leading to improving patient outcomes and quality of life.
尽管基于持续多巴胺能刺激（CDS）的治疗取得了令人鼓舞的结果，但左旋多巴缓释制剂的有效性仍存在争议。本荟萃分析旨在评估基于CDS的左旋多巴治疗对早中期帕金森病（PD）患者的有效性。
使用PubMed、EMBASE、Cochrane图书馆、科学网和ClinicalTrials.gov进行全面检索。纳入临床试验以比较基于CDS的左旋多巴治疗与间歇性左旋多巴（IL）治疗对早中期PD患者的效果。
本荟萃分析共纳入18项涉及2208例患者的临床试验。结果显示，与IL治疗相比，基于CDS的左旋多巴治疗使统一帕金森病评定量表（UPDRS）II评分（平均差（MD）-0.79，95%置信区间-1.26，-0.32）和UPDRS III评分（MD -1.03，95%置信区间-1.98，-0.08）显著降低。此外，基于CDS的治疗增加了无麻烦异动症的“开”期时间（MD 0.63，95%置信区间0.35，0.91）并减少了“关”期时间（MD -0.60，95%置信区间-1.03，-0.18）。在UPDRS II评分和UPDRS III评分的亚组分析中，200mg时MD分别为-0.62（95%置信区间-1.27，0.02）和-1.20（95%置信区间-4.74，2.34），左旋多巴与不同剂量其他药物联合使用时MD分别为-1.10（95%置信区间-1.88，-0.32）和-1.25（95%置信区间-3.26，0.76）。
基于CDS的左旋多巴治疗在管理早中期PD患者的运动症状和减少并发症方面具有显著益处。这些疗法为传统IL治疗提供了有前景的替代方案，可能会改善患者的治疗效果和生活质量。
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