Rasagiline for Parkinson's Disease: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 TONGYu-shan ,  YANGXin-ling

Cadre Ward, The Third Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China;

Corresponding?author：

YANGXin-ling, Email: poplar862@sohu.com

Keywords：

Parkinson's disease; Rasagiline; Monoamine oxidase type B inhibitor; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.20140036

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the effectiveness and safety of rasagiline for Parkinson's disease. Methods Databases including The Cochrane Library (Issue 3, 2013), Web of Science, MEDLINE (Ovid), PubMed, CBM, CNKI, WanFang Data and VIP were electronically searched from inception to March 2013 for randomized controlled trials (RCTs) on rasagiline for Parkinson's disease. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of included studies. Meta-analysis was performed using RevMan 5.1 software. Results In total, 6 studies involving 2 865 patients were included. The results of meta-analyses indicated that, compared with placebo, rasagiline 2 mg/d and 1 mg/d was significantly effective (MD=-3.16, 95%CI-3.21 to-3.11, P < 0.000 01; MD=-3.01, 95%CI-3.06 to-2.96, P < 0.000 01). Rasagiline 1 mg/d was more effective than rasagiline 2 mg/d in the treatment of early PD (MD=-0.65, 95%CI-0.73 to-0.57, P < 0.000 01). There was no significant difference between rasagiline and placebo in the incidences of nausea, headache, and dizziness (nausea:OR=0.72, 95%CI 0.49 to 1.07, P=0.60; headache:OR=1.02, 95%CI 0.70 to 1.49, P=0.91; dizziness:OR=0.87, 95%CI 0.49 to 1.55, P=0.35). Conclusion Rasagiline is effective for early Parkinson's disease, and the dosage 1 mg/d is better than 2 mg/d based on current limited evidence. Rasagiline has a good tolerance and safety. Due to the limited quantity of the included studies and the evidence with limited strength, further high-quality RCTs are needed to verify the aforementioned conclusion.

Citation： TONGYu-shan, YANGXin-ling. Rasagiline for Parkinson's Disease: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(2): 205-210. doi: 10.7507/1672-2531.20140036 Copy

1.	Nyholm D. Duodopa^? treatment for advanced Parkinson's disease:a review of efficacy and safety. Parkinsonism Relat Disord, 2012, 18(8):916-929.
2.	Chen JJ, Swope DM. Clinical pharmacology of rasagiline:a novel, second-generation propargylamine for the treatment of Parkinson disease. J Clin Pharmacol, 2005, 45(8):878-894.
3.	Suchowersky O, Reich S, Perlmutter J, et al. Practice parameter:diagnosis and prognosis of new onset Parkinson disease(an evidencebased review):report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2006, 66(7):968-975.
4.	鄧可剛.循證醫學證據的檢索步驟與檢索系統的選擇.中國循證醫學雜志, 2004, 4(9):634-637.
5.	Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. Available at: http://www.cochranehandbook.org.[2013-03-20].
6.	劉鳴.臨床研究選擇和納入.劉鳴, 主編.系統評價、Meta-分析設計與實施方法.第1版.北京:人民衛生出版社, 2011:97-108.
7.	陳耀龍, 李幼平, 杜亮, 等.醫學研究中證據分級和推薦強度的演進.中國循證醫學雜志, 2008, 8(2):127-133.
8.	袁金秋, 劉雅莉, 楊克虎, 等.系統評價在評價納入研究的質量評價方法調查.中國循證醫學雜志, 2012, 12(2):238-242.
9.	Parkinson Study Group. A randomized placebo-controlled trial of rasagiline in levodopa-treated patients with Parkinson disease and motor fluctuations:the PRESTO study. Arch Neurol, 2005, 62(2):241-248.
10.	Rascol O, Brooks DJ, Melamed E, et al. Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations(LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily study):a randomised, double-blind, parallel-group trial. Lancet, 2005, 365(1):947-954.
11.	Parkinson Study Group. A controlled trial of rasagiline in early Parkinson disease:the TEMPO Study. Arch Neurol, 2002, 59(1):1937-1943.
12.	Stern MB, Marek KL, Friedman J, et al. Double-blind, randomized, controlled trial of rasagiline as monotherapy in early Parkinson's disease patients. Mov Disord, 2004, 19(8):916-923.
13.	Olanow CW, Rascol O, Hauser R, et al. A double-blind, delayedstart trial of rasagiline in Parkinson's disease. N Engl J Med, 2009, 361(13):1268-1278.
14.	Rabey JM, Sagi I, Huberman M, et al. Rasagiline Mesylate, a New Mao-B Inhibitor for the Treatment of Parkinson's Disease:A Double-Blind Study as Adjunctive Therapy to Levodopa. Clin Neuropharmacol, 2000, 23(6):324-330.
15.	Kathryn DG, Vanessa KH. Adjunctive therapy in Parkinson's disease:the role of rasagiline. Neuropsychiatr Dis Treat, 2012, 9(1):285-294.
16.	Bar-Am O, Weinreb O, Amit T, et al. The neuroprotective mechanism of 1-(R)-aminoindan, the major metabolite of the anti-parkinsonian drug rasagiline. J Neurochem, 2010, 112(5):1131-1137.
17.	Swarztrauber K, Koudelka C, Brodsky MA. Initial pharmacotherapy in population of veterans with parkinson diesase. Neurology, 2006, 66(9):1425-1426.
18.	Keating GM, Lyseng-Williamson KA, Hoy SM. Rasagiline:a guide to its use in Parkinson's disease. CNS Drugs, 2012, 26(9):781-785.
19.	Olanow CW, Myllyla VV, Sotaniemi KA, et al. Effect of Selegiline on mortality in partients with Parkinson's disease:a meta-analysis. Neurology, 1998, 51(3):825-830.
20.	Przuntek H, Conrad B, Dichgans J, et al. SELEDO:a 5-year longterm trial on the effect of Selegiline in early Parkinsonian patients treated with levodopa. Eur J Neurol, 1999, 6(2):141-150.
21.	The Parkinson Study Group. Effect of lazabemide on the progression of disability in early Parkinson's disease. Ann Neurol, 1996, 40(1):99-107.

1. Nyholm D. Duodopa^? treatment for advanced Parkinson's disease:a review of efficacy and safety. Parkinsonism Relat Disord, 2012, 18(8):916-929.
2. Chen JJ, Swope DM. Clinical pharmacology of rasagiline:a novel, second-generation propargylamine for the treatment of Parkinson disease. J Clin Pharmacol, 2005, 45(8):878-894.
3. Suchowersky O, Reich S, Perlmutter J, et al. Practice parameter:diagnosis and prognosis of new onset Parkinson disease(an evidencebased review):report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2006, 66(7):968-975.
4. 鄧可剛.循證醫學證據的檢索步驟與檢索系統的選擇.中國循證醫學雜志, 2004, 4(9):634-637.
5. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. Available at: http://www.cochranehandbook.org.[2013-03-20].
6. 劉鳴.臨床研究選擇和納入.劉鳴, 主編.系統評價、Meta-分析設計與實施方法.第1版.北京:人民衛生出版社, 2011:97-108.
7. 陳耀龍, 李幼平, 杜亮, 等.醫學研究中證據分級和推薦強度的演進.中國循證醫學雜志, 2008, 8(2):127-133.
8. 袁金秋, 劉雅莉, 楊克虎, 等.系統評價在評價納入研究的質量評價方法調查.中國循證醫學雜志, 2012, 12(2):238-242.
9. Parkinson Study Group. A randomized placebo-controlled trial of rasagiline in levodopa-treated patients with Parkinson disease and motor fluctuations:the PRESTO study. Arch Neurol, 2005, 62(2):241-248.
10. Rascol O, Brooks DJ, Melamed E, et al. Rasagiline as an adjunct to levodopa in patients with Parkinson's disease and motor fluctuations(LARGO, Lasting effect in Adjunct therapy with Rasagiline Given Once daily study):a randomised, double-blind, parallel-group trial. Lancet, 2005, 365(1):947-954.
11. Parkinson Study Group. A controlled trial of rasagiline in early Parkinson disease:the TEMPO Study. Arch Neurol, 2002, 59(1):1937-1943.
12. Stern MB, Marek KL, Friedman J, et al. Double-blind, randomized, controlled trial of rasagiline as monotherapy in early Parkinson's disease patients. Mov Disord, 2004, 19(8):916-923.
13. Olanow CW, Rascol O, Hauser R, et al. A double-blind, delayedstart trial of rasagiline in Parkinson's disease. N Engl J Med, 2009, 361(13):1268-1278.
14. Rabey JM, Sagi I, Huberman M, et al. Rasagiline Mesylate, a New Mao-B Inhibitor for the Treatment of Parkinson's Disease:A Double-Blind Study as Adjunctive Therapy to Levodopa. Clin Neuropharmacol, 2000, 23(6):324-330.
15. Kathryn DG, Vanessa KH. Adjunctive therapy in Parkinson's disease:the role of rasagiline. Neuropsychiatr Dis Treat, 2012, 9(1):285-294.
16. Bar-Am O, Weinreb O, Amit T, et al. The neuroprotective mechanism of 1-(R)-aminoindan, the major metabolite of the anti-parkinsonian drug rasagiline. J Neurochem, 2010, 112(5):1131-1137.
17. Swarztrauber K, Koudelka C, Brodsky MA. Initial pharmacotherapy in population of veterans with parkinson diesase. Neurology, 2006, 66(9):1425-1426.
18. Keating GM, Lyseng-Williamson KA, Hoy SM. Rasagiline:a guide to its use in Parkinson's disease. CNS Drugs, 2012, 26(9):781-785.
19. Olanow CW, Myllyla VV, Sotaniemi KA, et al. Effect of Selegiline on mortality in partients with Parkinson's disease:a meta-analysis. Neurology, 1998, 51(3):825-830.
20. Przuntek H, Conrad B, Dichgans J, et al. SELEDO:a 5-year longterm trial on the effect of Selegiline in early Parkinsonian patients treated with levodopa. Eur J Neurol, 1999, 6(2):141-150.
21. The Parkinson Study Group. Effect of lazabemide on the progression of disability in early Parkinson's disease. Ann Neurol, 1996, 40(1):99-107.

Chinese Journal of Evidence-Based Medicine

Rasagiline for Parkinson's Disease: A Meta-Analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content