B型单胺氧化酶抑制剂治疗早期帕金森病:对3525例患者17项随机试验的荟萃分析

作     者：Ives N.J. Stowe R.L. Marro J. 黄卫东 

作者机构：Birmingham Clinical Trials Unit University of Birmingham Birming ham B15 2RR United Kingdom 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第2期

页      面：1-2页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：早期帕金森 B型单胺氧化酶 左旋多巴 帕金森病 荟萃分析 运动症状 临床功能 抗帕金森病药物 评分量表 随机试验 

摘      要：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 We b of Science for years 1966-2003, plus major journals in the field, abstract bo oks, and proceedings of meetings, for randomised trials comparing MAOBIs with pl acebo or levodopa. Data extraction: Available data on mortality, motor complicat ions, side effects, treatment compliance, and clinician rated disability (for ex ample, unified Par kinsons disease rating scale) were extracted from 17 trial s and combined using standard meta analytic methods. Results: No significant di fference in mortality existed between patients on MAOBIs and control patients (o dds ratio 1.13, 95%confidence interval 0.94 to 1.34; P=0.2). Patients randomise d 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 nee d additional levodopa (0.57, 0.48 to 0.67; P 0.00001) or to develop motor fluc tuations (0.75, 0.59 to 0.95; P = 0.02). No difference existed between the two g roups in the incidence of side effects or withdrawal of patients. Conclusions: M AOBIs reduce disability, the need for levodopa, and the incidence of motor fluct uations, without substantial side effects or increased mortality. However, becau se few trials have compared MAOBIs with other antiparkinsonian drugs, uncertaint y remains about the relative benefits and risks of MAOBIs. Further large, long t erm comparative trials that include patient rated quality of life measures are n eeded.