Efficacy of preladenant in improving motor symptoms in Parkinson's disease: A systematic review and meta-analysis.

Background: Parkinson's disease (PD) is a complex neurodegenerative disorder characterized by dopamine depletion and severe motor impairments. Preladenant, an adenosine A2 receptor antagonist, is an investigational treatment for PD. This systematic review and meta-analysis aimed to critically evaluate the efficacy of Preladenant in improving motor symptoms in patients with PD. Methods: A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Central Register of Controlled Trials from inception to March 2023, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) comparing Preladenant with placebo in PD patients were included. The primary outcome was the change in daily ON time without troublesome dyskinesia. Secondary outcomes included the change in daily OFF time and adverse events. The risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Four RCTs with a total of 2097 PD patients were included. Pooled analysis showed that Preladenant could generally increase daily ON time (pooled effect 0.15 and 95 % CI: -0.19-0.48) and reduce daily OFF time (pooled effect -0.04 and 95 % CI: -0.43-0.36) compared to placebo, however it was not significant. The included studies had moderate to high heterogeneity. No significant differences in adverse events were observed between Preladenant and placebo. Conclusion: This meta-analysis suggests that Preladenant may improve motor fluctuations in PD patients by increasing ON time and reducing OFF time. However, the high heterogeneity among studies warrants further large-scale, high-quality RCTs to confirm these findings and establish the long-term safety and efficacy of Preladenant in PD management.

Assessing the Impact of Bariatric Surgery on Retinol-Binding Protein 4 (RBP4): A Systematic Review and Meta-Analysis.

This study aimed to analyze changes in retinol-binding protein 4 (RBP4) levels before and after bariatric surgery in obese individuals. Bariatric surgery is a safe and effective treatment for morbid obesity, impacting molecules like RBP4. A systematic review and meta-analysis of 12 relevant studies were conducted, utilizing databases such as PubMed, Cochrane Central, Web of Science, and Scopus. Significant differences in RBP4, glucose, and BMI levels pre- and post-surgery were observed. Meta-regression analysis explored associations with age, pre-BMI, triglycerides, glucose, and post-insulin levels. Findings suggest RBP4 may improve insulin sensitivity after bariatric surgery, warranting further investigation as a potential pharmacotherapeutic target. These results highlight the importance of understanding RBP4's role in the context of bariatric surgery and its implications for improving metabolic health in obese individuals.

The Effect of Bariatric Surgery on Irisin Level: a Systematic Review and Meta-analysis.

This systematic analysis and meta-analysis aimed to assess changes in the plasma levels of irisin after bariatric surgery. Search strategy, study screening, and data gathering were all conducted using a checklist and the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Two researchers independently extracted the data, and a third person was included to resolve disagreements. The results illustrated no statistical difference between before and after surgery irisin plasma levels (P = 0.216, 95% CI = -1.812-0.410, SMD = -0.701, I-squared = 94.9%). BMI exhibited a meaningful decline after surgery compared to preoperative values (SMD = -3.09, 95% CI = -4.59--1.59, I-squared = 95.5%, P<0.05). According to our analysis, it can be concluded that irisin plasma levels are not significantly influenced by bariatric surgery.