Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients
Identifieur interne : 001606 ( Main/Exploration ); précédent : 001605; suivant : 001607Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients
Auteurs : Natalie J. Ives ; Rebecca L. Stowe ; Joanna Marro ; Carl Counsell ; Angus Macleod ; Carl E. Clarke ; Richard Gray ; Keith WheatleySource :
- BMJ [ 0959-8138 ] ; 2004-09-11.
Abstract
Objective To quantify more reliably the benefits and risks of monoamine oxidase type B inhibitors (MAOBIs) in early Parkinson's disease. Data sources Searches of the Cochrane Library, Medline, Embase, PubMed, and Web of Science for years 1966-2003, plus major journals in the field, abstract books, and proceedings of meetings, for randomised trials comparing MAOBIs with placebo or levodopa. Data extraction Available data on mortality, motor complications, side effects, treatment compliance, and clinician rated disability (for example, unified Parkinson's disease rating scale) were extracted from 17 trials and combined using standard meta-analytic methods. Results No significant difference in mortality existed between patients on MAOBIs and control patients (odds ratio 1.13, 95% confidence interval 0.94 to 1.34; P = 0.2). Patients randomised to MAOBIs had significantly better total scores, motor scores, and activities of daily living scores on the unified Parkinson's disease rating scale at three months compared with patients taking placebo; they were also less likely to need additional levodopa (0.57, 0.48 to 0.67; P < 0.00001) or to develop motor fluctuations (0.75, 0.59 to 0.95; P = 0.02). No difference existed between the two groups in the incidence of side effects or withdrawal of patients. Conclusions MAOBIs reduce disability, the need for levodopa, and the incidence of motor fluctuations, without substantial side effects or increased mortality. However, because few trials have compared MAOBIs with other antiparkinsonian drugs, uncertainty remains about the relative benefits and risks of MAOBIs. Further large, long term comparative trials that include patient rated quality of life measures are needed.
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DOI: 10.1136/bmj.38184.606169.AE
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Stowe</name></author><author><name sortKey="Marro, Joanna" sort="Marro, Joanna" uniqKey="Marro J" first="Joanna" last="Marro">Joanna Marro</name></author><author><name sortKey="Counsell, Carl" sort="Counsell, Carl" uniqKey="Counsell C" first="Carl" last="Counsell">Carl Counsell</name></author><author><name sortKey="Macleod, Angus" sort="Macleod, Angus" uniqKey="Macleod A" first="Angus" last="Macleod">Angus Macleod</name></author><author><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name></author><author><name sortKey="Gray, Richard" sort="Gray, Richard" uniqKey="Gray R" first="Richard" last="Gray">Richard Gray</name></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:271BF03B40C999EEC2641E2AA499CA3BD3A8391F</idno><date when="2004" year="2004">2004</date><idno type="doi">10.1136/bmj.38184.606169.AE</idno><idno type="url">https://api.istex.fr/document/271BF03B40C999EEC2641E2AA499CA3BD3A8391F/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001458</idno><idno type="wicri:Area/Main/Curation">001239</idno><idno type="wicri:Area/Main/Exploration">001606</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients</title><author><name sortKey="Ives, Natalie J" sort="Ives, Natalie J" uniqKey="Ives N" first="Natalie J" last="Ives">Natalie J. 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Clarke</name><affiliation><wicri:noCountry code="subField">Birmingham B18 7QH</wicri:noCountry></affiliation></author><author><name sortKey="Gray, Richard" sort="Gray, Richard" uniqKey="Gray R" first="Richard" last="Gray">Richard Gray</name><affiliation><wicri:noCountry code="subField">Birmingham B15 2RR</wicri:noCountry></affiliation></author><author><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name><affiliation><wicri:noCountry code="subField">Birmingham B15 2RR</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2004-09-11">2004-09-11</date><biblScope unit="volume">329</biblScope><biblScope unit="issue">7466</biblScope><biblScope unit="page" from="593">593</biblScope></imprint><idno type="ISSN">0959-8138</idno></series><idno type="istex">271BF03B40C999EEC2641E2AA499CA3BD3A8391F</idno><idno type="DOI">10.1136/bmj.38184.606169.AE</idno><idno type="href">bmj-329-593.pdf</idno><idno type="ArticleID">bmj.38184.606169.AE</idno><idno type="PMID">15310558</idno><idno type="local">bmj;329/7466/593</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective To quantify more reliably the benefits and risks of monoamine oxidase type B inhibitors (MAOBIs) in early Parkinson's disease. Data sources Searches of the Cochrane Library, Medline, Embase, PubMed, and Web of Science for years 1966-2003, plus major journals in the field, abstract books, and proceedings of meetings, for randomised trials comparing MAOBIs with placebo or levodopa. Data extraction Available data on mortality, motor complications, side effects, treatment compliance, and clinician rated disability (for example, unified Parkinson's disease rating scale) were extracted from 17 trials and combined using standard meta-analytic methods. Results No significant difference in mortality existed between patients on MAOBIs and control patients (odds ratio 1.13, 95% confidence interval 0.94 to 1.34; P = 0.2). Patients randomised to MAOBIs had significantly better total scores, motor scores, and activities of daily living scores on the unified Parkinson's disease rating scale at three months compared with patients taking placebo; they were also less likely to need additional levodopa (0.57, 0.48 to 0.67; P < 0.00001) or to develop motor fluctuations (0.75, 0.59 to 0.95; P = 0.02). No difference existed between the two groups in the incidence of side effects or withdrawal of patients. Conclusions MAOBIs reduce disability, the need for levodopa, and the incidence of motor fluctuations, without substantial side effects or increased mortality. However, because few trials have compared MAOBIs with other antiparkinsonian drugs, uncertainty remains about the relative benefits and risks of MAOBIs. Further large, long term comparative trials that include patient rated quality of life measures are needed.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Clarke, Carl E" sort="Clarke, Carl E" uniqKey="Clarke C" first="Carl E" last="Clarke">Carl E. Clarke</name><name sortKey="Counsell, Carl" sort="Counsell, Carl" uniqKey="Counsell C" first="Carl" last="Counsell">Carl Counsell</name><name sortKey="Gray, Richard" sort="Gray, Richard" uniqKey="Gray R" first="Richard" last="Gray">Richard Gray</name><name sortKey="Ives, Natalie J" sort="Ives, Natalie J" uniqKey="Ives N" first="Natalie J" last="Ives">Natalie J. Ives</name><name sortKey="Macleod, Angus" sort="Macleod, Angus" uniqKey="Macleod A" first="Angus" last="Macleod">Angus Macleod</name><name sortKey="Marro, Joanna" sort="Marro, Joanna" uniqKey="Marro J" first="Joanna" last="Marro">Joanna Marro</name><name sortKey="Stowe, Rebecca L" sort="Stowe, Rebecca L" uniqKey="Stowe R" first="Rebecca L" last="Stowe">Rebecca L. Stowe</name><name sortKey="Wheatley, Keith" sort="Wheatley, Keith" uniqKey="Wheatley K" first="Keith" last="Wheatley">Keith Wheatley</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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