Meta-analysis of rasagiline as monotherapy in early Parkinson's disease

ABSTRACT

INTRODUCTION: Parkinson's disease (PD) is a second most common neurodegenerative disorder which affects 1 % to 2% of people older than 60 years and is characterized by cardinal features of bradykinesia, rigidity, and rest tremor (2). Most of the motor disability experienced by patients results from progressive loss of dopaminergic neurons of the Substantia Nigra pars compacta (SNpc). However, recent studies have shown that PD is also associated with extensive non-dopaminergic pathology. Recent trend in the treatment of PD include development of new drugs that will not only address the symptom relief but will also ameliorate the progression of dopaminergic neuron degeneration (3).OBJECTIVE: To assess the evidence from randomized controlled trials the effects of Rasagiline compared with placebo in the treatment of patients with Parkinson's diseaseDESIGN: Meta-analysis of 3 randomized trials identified through Medline/Pubmed and Cochrane Library. Summary of the outcome variables was computed using difference of two means of the United Parkinson's disease rating scale (UPDRS) score and their corresponding standard error of the means under fixed effects models. The chi-square test was done to test heterogeneity. Statistical analysis was done using Revman version 5.RESULTS: The sample size of the studies ranged from 13 to 595 patients. The mean age of the trial participants were in the 60s with a relatively narrow standard deviation. All studies were randomized and placebo controlled. The main outcome measure was change in the UPDRS score from baseline. The mean difference between Rasagiline 1 mg and placebo is -3.06 (95% CI -3.81, -2.31) and Rasagiline 2mg and placebo is -3.17 (95% CI -3.92, -2.42). The overall effect was statistically significant (z=8.01; pCONCLUSION: Based on this meta-analysis, Rasagiline is effective as monotherapy in early Parkinson's disease.