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Rasagiline combined with levodopa therapy versus levodopa monotherapy for patients with Parkinson’s disease: a systematic review

  • De-Qi JiangEmail author
  • Hua-Kun Wang
  • Yan Wang
  • Ming-Xing Li
  • Li-Lin Jiang
  • Yong Wang
Original Article

Abstract

Objective

The aim of this report was to systematically evaluate the efficacy and safety of rasagiline (R) plus levodopa (l) (R + l) for the treatment of Parkinson’s disease (PD) compared with that of l monotherapy, in order to provide a reference resource for rational drug use.

Methods

Randomized controlled trials (RCTs) of R + l for PD published up to September 2018 were searched. Sensitivity analyses were also performed.

Results

Fourteen RCTs with 2531 participants were included. Compared with l monotherapy, the pooled effects of R + l combination therapy on unified Parkinson’s disease rating scale (UPDRS) score were (SMD − 0.50, 95% CI − 0.70 to − 0.30, P < 0.00001) for UPDRS motor score, (SMD − 0.59, 95% CI − 0.79 to − 0.39, P < 0.00001) for UPDRS activities of daily living (ADL) score, (SMD − 0.65, 95% CI − 0.81 to − 0.49, P < 0.00001) for UPDRS total score. R + l combination therapy was better than l monotherapy in reducing daily off-time (SMD − 1.15, 95% CI − 2.13 to − 0.17, P = 0.02), but there was a statistically nonsignificant result in daily on-time increase (SMD 1.39, 95% CI − 0.69 to 3.48, P = 0.19). There were no statistical differences in number of adverse events (OR 1.33, 95% CI 0.97 to 1.82, P = 0.07) and number of dropout (OR 0.88, 95% CI 0.65 to 1.19, P = 0.39) between R + l combination therapy and l monotherapy.

Conclusions

R + l combination therapy was superior to l monotherapy for improvement of UPDRS scores and off-time in PD patients. Moreover, R + l combination therapy and l monotherapy were similar in terms of safety and tolerability.

Keywords

Rasagiline Levodopa Parkinson’s disease Motor Off-time Systematic review 

Notes

Funding information

This study was supported by grants from the Natural Science Foundation of Guangxi Zhuang Autonomous Region of China (No. 2018GXNSFAA050002) and the Doctoral Scientific Research Foundation of Yulin Normal University of China (No. G20160006).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10072_2019_4050_MOESM1_ESM.doc (58 kb)
ESM 1 (DOC 58 kb)
10072_2019_4050_MOESM2_ESM.docx (14 kb)
ESM 2 (DOCX 14 kb)

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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Department of Biology and Pharmacy, Guangxi Key Laboratory of Agricultural Resources Chemistry and BiotechnologyYulin Normal UniversityYulinChina
  2. 2.Department of PharmacyGuangdong Province Hospital of Integrated Traditional Chinese and Western MedicineFoshanChina
  3. 3.Department of Pharmacy, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
  4. 4.Department of PharmacyZhujiang Hospital of Southern Medical UniversityGuangzhouChina

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