Abstract

BACKGROUND
Levodopa is considered the gold standard therapy for Parkinson's disease (PD). Aspiration pneumonia is the most frequent cause of death among PD patients. Asymptomatic respiratory impairment can be detected even in the initial stages of the disease course; however, there is no conclusive evidence regarding the efficacy of levodopa, the main therapeutic drug for PD, to enhance pulmonary function in these patients.
OBJECTIVE
The aim of this systematic review and meta-analysis was to evaluate the effects of levodopa therapy on respiratory parameters in patients with PD.
METHODS
After a comprehensive and systematic literature search in the electronic databases MEDLINE, Embase, the Cochrane Library, and Web of Science, all trials referring to levodopa and respiratory function that met the eligibility criteria were included in the analysis. Considered outcomes were forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)), the ratio between FEV(1) and FVC (FEV(1)/FVC), and peak expiratory flow (PEF). The fixed effects model was used to assess the weighted mean difference, and heterogeneity between studies was calculated with the I(2) test.
RESULTS
Four clinical trials comprising 73 patients and assessing the effects of levodopa on pulmonary function in patients with PD were included in the analysis. Pooled data showed that levodopa significantly improved FVC (SMD, 0.40; P = 0.02) and PEF (standard mean difference, 0.39; P = 0.03). No significant change was observed with FEV(1) (SMD, 0.34; P = 0.05) or the FEV(1)/FVC ratio (standard mean difference, -0.08; P = 0.66) after levodopa therapy.
CONCLUSIONS
The results of this systematic review suggest that levodopa therapy improved FVC and PEF, whereas no changes were observed in FEV(1) and FEV(1)/FVC. These findings may provide some indirect evidence regarding the efficacy of levodopa in restrictive parameters of pulmonary function.

Links

Publisher Full Text

Authors

Monteiro L, Souza-Machado A, Valderramas S, Melo A

Institution

Division of Neurology and Epidemiology, Federal University of Bahia, Salvador-Bahia, Brazil. menezes.lari@gmail.com

Source

Clinical therapeutics 34:5 2012 May pg 1049-55

MeSH

Antiparkinson Agents
Forced Expiratory Volume
Humans
Levodopa
Lung Diseases
Models, Statistical
Parkinson Disease
Peak Expiratory Flow Rate
Vital Capacity

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22465616