普拉克索治疗帕金森病有效性和安全性的meta分析

目的通过对普拉克索治疗帕金森病(PD)的临床随机对照研究进行Meta分析,探讨普拉克索的药效和安全性,为临床安全合理使用该药提供依据。方法计算机检索Ovid Medline(1966年~2009年3月),图书馆临床试验和专业资料库,Cochrane图书馆临床对照试验资料库(ACP Journal C1ub;Cochrane Central Register ofControlled Trials CENTRAL,2008年),中国生物医学文献数据库(1990~2008年),同时检索相关文献的参考文献。应用Cochrane协作网提供的Rev Man4.28软件系统评价,对普拉克索治疗PD的随机对照试验进行Meta分析。结果共纳入6个随机对照试验,包括普拉克索组898例患者,安慰剂对照组813例患者。Meta分析结果显示:(1)帕金森病评定量表(UPDRS)第Ⅱ部分评分相对基线的变化取加权均数差进行meta分析。普拉克索组和安慰剂组之间差异(WMD=-2.35,95%CI-2.92,-1.79],P<0.01),差异有统计学意义。UPDRSⅢ评分相对基线的变化取加权均数差进行meta分析。普拉克索组和对照组之间...

A Meta-analysis of pramipexole in Parkinson' s disease

Objective In comparative trials a meta-analysis was performed to compare the efficacy and adverse events of pramipexole and placebo as reported in the peer-reviewed medical literature. Methods We systematically reviewed the medical literature to identify randomized controlled trials of pramipexole and placebo used in the management of Parkinson' s disease. Computerised databases (including Cochrane Central Register of Controlled Trials (CENTRAL),Medline (1966～2009) ,Embase (1974～2009) and Chinese National Knowledge Infrastructure database (CNKI)) were used to identify pertinent articles for inclusion in this study. Randomized controlled trials published in the English and Chinese literature comparing the effect of pramipexole with placebo in Parkinson' s Disease were eligible for inclusion. Two investigators independently assessed the quality and extracted the data. Results Six randomized controlled with a total number of 898 in pramipexole group and 813 in placebo group was identified. By Meta-analysis of all studies,we concluded there is an obvious decrease of endpoints(UPDRS Ⅱ ,UPDRS Ⅲ and responder rate) in pramipexole group. No significant publication bias was found,funnel plots did not suggest evidence of significant bias. Meta-analysis of adverse events of pramipexole compared to placebo indicated OR > 1 for dyskinesia,dizziness,hallucination,somnolence,insomnia,nausea > 1 ,which meant pramipexole may induce these adverse events. However,there were no significant differences in the incidence of orthostatic hypoteusion between the two groups. Conclusion Pramipexole is a efficacious and promising option in the treatment of paitient with Parkison's disease. Pramipexole can be used to improve motor impairments and disability,but it can also increase the incidence of hallucination,somnolence,insomnia and some other adverse events. Further studies are needed to compare this dopamine agonist directly with existing therapies to elucidate its role in the PD treatmem.