Tags

Type your tag names separated by a space and hit enter

Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients.
BMJ. 2004 Sep 11; 329(7466):593.BMJ

Abstract

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 Web of Science for years 1966-2003, plus major journals in the field, abstract books, and proceedings of meetings, for randomised trials comparing MAOBIs with placebo or levodopa.

DATA EXTRACTION

Available data on mortality, motor complications, side effects, treatment compliance, and clinician rated disability (for example, unified Parkinson's disease rating scale) were extracted from 17 trials and combined using standard meta-analytic methods.

RESULTS

No significant difference in mortality existed between patients on MAOBIs and control patients (odds ratio 1.13, 95% confidence interval 0.94 to 1.34; P = 0.2). Patients randomised 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 need additional levodopa (0.57, 0.48 to 0.67; P < 0.00001) or to develop motor fluctuations (0.75, 0.59 to 0.95; P = 0.02). No difference existed between the two groups in the incidence of side effects or withdrawal of patients.

CONCLUSIONS

MAOBIs reduce disability, the need for levodopa, and the incidence of motor fluctuations, without substantial side effects or increased mortality. However, because few trials have compared MAOBIs with other antiparkinsonian drugs, uncertainty remains about the relative benefits and risks of MAOBIs. Further large, long term comparative trials that include patient rated quality of life measures are needed.

Authors+Show Affiliations

Birmingham Clinical Trials Unit, University of Birmingham, Birmingham B15 2RR. n.j.ives@bham.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15310558

Citation

Ives, Natalie J., et al. "Monoamine Oxidase Type B Inhibitors in Early Parkinson's Disease: Meta-analysis of 17 Randomised Trials Involving 3525 Patients." BMJ (Clinical Research Ed.), vol. 329, no. 7466, 2004, p. 593.
Ives NJ, Stowe RL, Marro J, et al. Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients. BMJ. 2004;329(7466):593.
Ives, N. J., Stowe, R. L., Marro, J., Counsell, C., Macleod, A., Clarke, C. E., Gray, R., & Wheatley, K. (2004). Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients. BMJ (Clinical Research Ed.), 329(7466), 593.
Ives NJ, et al. Monoamine Oxidase Type B Inhibitors in Early Parkinson's Disease: Meta-analysis of 17 Randomised Trials Involving 3525 Patients. BMJ. 2004 Sep 11;329(7466):593. PubMed PMID: 15310558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients. AU - Ives,Natalie J, AU - Stowe,Rebecca L, AU - Marro,Joanna, AU - Counsell,Carl, AU - Macleod,Angus, AU - Clarke,Carl E, AU - Gray,Richard, AU - Wheatley,Keith, Y1 - 2004/08/13/ PY - 2004/8/18/pubmed PY - 2004/9/25/medline PY - 2004/8/18/entrez SP - 593 EP - 593 JF - BMJ (Clinical research ed.) JO - BMJ VL - 329 IS - 7466 N2 - 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 Web of Science for years 1966-2003, plus major journals in the field, abstract books, and proceedings of meetings, for randomised trials comparing MAOBIs with placebo or levodopa. DATA EXTRACTION: Available data on mortality, motor complications, side effects, treatment compliance, and clinician rated disability (for example, unified Parkinson's disease rating scale) were extracted from 17 trials and combined using standard meta-analytic methods. RESULTS: No significant difference in mortality existed between patients on MAOBIs and control patients (odds ratio 1.13, 95% confidence interval 0.94 to 1.34; P = 0.2). Patients randomised 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 need additional levodopa (0.57, 0.48 to 0.67; P < 0.00001) or to develop motor fluctuations (0.75, 0.59 to 0.95; P = 0.02). No difference existed between the two groups in the incidence of side effects or withdrawal of patients. CONCLUSIONS: MAOBIs reduce disability, the need for levodopa, and the incidence of motor fluctuations, without substantial side effects or increased mortality. However, because few trials have compared MAOBIs with other antiparkinsonian drugs, uncertainty remains about the relative benefits and risks of MAOBIs. Further large, long term comparative trials that include patient rated quality of life measures are needed. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/15310558/Monoamine_oxidase_type_B_inhibitors_in_early_Parkinson's_disease:_meta_analysis_of_17_randomised_trials_involving_3525_patients_ L2 - https://www.bmj.com/lookup/pmidlookup?view=long&amp;pmid=15310558 DB - PRIME DP - Unbound Medicine ER -