Objective: This study aimed to investigate the effectiveness of dopamine agonists or monoamine oxidase type B inhibitors (MAOB-I) as monotherapy in patients with early Parkinson’s disease (PD) using network meta-analysis.
Background: Clinical trials have suggested dopamine agonists or MAOB-I inhibitors as therapeutic options for early PD. To compare and rank the effectiveness and safety of these medications as monotherapy, a network meta-analysis was performed.
Method: We searched various databases for randomized controlled trials that enrolled early PD patients treated with dopamine agonists or MAOB-I as monotherapy were identified. Data were pooled using pairwise analysis and network meta-analysis (NMA), summarized as mean difference (MD) with 95% confidence interval (CI) and visualized in forest plots and tables. Surface under the cumulative ranking curve (SUCRA) plots were used to determine the ranking probability.
Results: A total of 10 randomized controlled trials with 2,375 patients were included. In comparison to placebo on the Unified Parkinson’s Disease Rating Scale (UPDRS) III score change, pairwise meta-analysis showed a mean difference of -4.01 (CI: -6.63 to -1.38) for promipexole_ER, -4.56 (CI: -6.84 to -2.28) for promipexole_IR, -2.83 (CI: −5.21 to −0.46) for rotigotine, -2.70 (CI: -8.91 to 3.51) for safinamide, -2.57 (CI: -4.98 to -0.15) for rasagiline, and -6.21 (CI: -8.70 to -3.73) for selegiline. The ranking of mean change in motor score from high to low was selegiline (SUCRA = 88.09%), promipexole_IR (SUCRA = 69.71%), promipexole_ER (SUCRA = 59.66%), safinamide (SUCRA = 44.20%), rotigotine (SUCRA = 42.98%), and rasagiline (SUCRA = 39.23%).
Conclusion: This network meta-analysis suggests that pramipexole, rotigotine, rasagiline, and selegiline are effective monotherapy options for patients with early PD.
To cite this abstract in AMA style:CSC. Chuang. The efficacy of dopamine agonists or monoamine oxidase type B inhibitors as monotherapy in patients with early Parkinson disease: A network meta-analysis [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/the-efficacy-of-dopamine-agonists-or-monoamine-oxidase-type-b-inhibitors-as-monotherapy-in-patients-with-early-parkinson-disease-a-network-meta-analysis/. Accessed September 28, 2023.
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