Nonergot dopamine-receptor agonists for treating Parkinson’s disease – a network meta-analysis
Identifieur interne : 000990 ( Main/Exploration ); précédent : 000989; suivant : 000991Nonergot dopamine-receptor agonists for treating Parkinson’s disease – a network meta-analysis
Auteurs : Kristian Thorlund [Canada, États-Unis] ; Ping Wu [Canada] ; Eric Druyts [Canada] ; Shawn Eapen [Canada] ; Edward J. Mills [États-Unis, Canada]Source :
- Neuropsychiatric Disease and Treatment [ 1176-6328 ] ; 2014.
Abstract
To compare the efficacy of the three nonergot dopamine-receptor agonists (DAs) pramipexole, ropinirole, and rotigotine for the treatment of early and advanced Parkinson’s disease (PD).
Bayesian network meta-analyses were performed separately for early and advanced PD, and at time points 11–16 and 24–28 weeks. Outcomes for early PD included improvement on the Unified Parkinson’s Disease Rating Scale (UPDRS) activities in daily life (UPDRS-II), motor function (UPDRS-III), and their subtotal (UPDRS-II + III). Outcomes for advanced PD also included daily “off time” (hours), but not UPDRS-II + III.
Totals of 23 and 24 trials informed early and advanced PD analyses. For early PD UPDRS-II at 11–16 weeks, pramipexole and rotigotine were statistically significantly superior to placebo, but ropinirole was not. For UPDRS-III and UPDRS-II + III, all DAs were statistically significantly better than placebo and exhibited similar improvements. At 24–28 weeks, results were also statistically significant for all DAs versus placebo, and the magnitudes of improvements were similar for pramipexole, ropinirole and rotigotine. Advanced PD improvements on UPDRS-II, UPRDS-III, and off time were statistically significant for pramipexole, ropinirole, and rotigotine versus placebo. At 11–16 weeks, rotigotine yielded slightly smaller effects than ropinirole and pramipexole, but credible intervals on differences were wide. For off time, results were near identical. At 24–28 weeks, results were similar for all three outcomes. Ropinirole yielded a slightly higher improvement on UPDRS-III, but a slightly smaller improvement in off time.
Our analyses suggest that pramipexole, ropinirole, and rotigotine exhibit similar efficacy in the treatment of early and advanced PD.
Url:
DOI: 10.2147/NDT.S60061
PubMed: 24855362
PubMed Central: 4019622
Affiliations:
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Le document en format XML
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<series><title level="j">Neuropsychiatric Disease and Treatment</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To compare the efficacy of the three nonergot dopamine-receptor agonists (DAs) pramipexole, ropinirole, and rotigotine for the treatment of early and advanced Parkinson’s disease (PD).</p>
</sec>
<sec><title>Materials and methods</title>
<p>Bayesian network meta-analyses were performed separately for early and advanced PD, and at time points 11–16 and 24–28 weeks. Outcomes for early PD included improvement on the Unified Parkinson’s Disease Rating Scale (UPDRS) activities in daily life (UPDRS-II), motor function (UPDRS-III), and their subtotal (UPDRS-II + III). Outcomes for advanced PD also included daily “off time” (hours), but not UPDRS-II + III.</p>
</sec>
<sec><title>Results</title>
<p>Totals of 23 and 24 trials informed early and advanced PD analyses. For early PD UPDRS-II at 11–16 weeks, pramipexole and rotigotine were statistically significantly superior to placebo, but ropinirole was not. For UPDRS-III and UPDRS-II + III, all DAs were statistically significantly better than placebo and exhibited similar improvements. At 24–28 weeks, results were also statistically significant for all DAs versus placebo, and the magnitudes of improvements were similar for pramipexole, ropinirole and rotigotine. Advanced PD improvements on UPDRS-II, UPRDS-III, and off time were statistically significant for pramipexole, ropinirole, and rotigotine versus placebo. At 11–16 weeks, rotigotine yielded slightly smaller effects than ropinirole and pramipexole, but credible intervals on differences were wide. For off time, results were near identical. At 24–28 weeks, results were similar for all three outcomes. Ropinirole yielded a slightly higher improvement on UPDRS-III, but a slightly smaller improvement in off time.</p>
</sec>
<sec><title>Conclusion</title>
<p>Our analyses suggest that pramipexole, ropinirole, and rotigotine exhibit similar efficacy in the treatment of early and advanced PD.</p>
</sec>
</div>
</front>
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</TEI>
<affiliations><list><country><li>Canada</li>
<li>États-Unis</li>
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<region><li>Ontario</li>
</region>
<settlement><li>Hamilton (Ontario)</li>
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<orgName><li>Université McMaster</li>
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