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  • Antonini, AngeloUniversity of Padova (author)

Comparative Effectiveness of Device-Aided Therapies on Quality of Life and Off-Time in Advanced Parkinson’s Disease : A Systematic Review and Bayesian Network Meta-analysis

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • 2022-11-21
  • Springer Science and Business Media LLC,2022
  • 15 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:ef8e9499-b83a-4233-94ec-8932072ffbba
  • https://lup.lub.lu.se/record/ef8e9499-b83a-4233-94ec-8932072ffbbaURI
  • https://doi.org/10.1007/s40263-022-00963-9DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:for swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Introduction: Research comparing levodopa/carbidopa intestinal gel (LCIG), deep brain stimulation (DBS), and continuous subcutaneous apomorphine infusion (CSAI) for advanced Parkinson’s disease (PD) is lacking. This network meta-analysis (NMA) assessed the comparative effectiveness of LCIG, DBS, CSAI and best medical therapy (BMT) in reducing off-time and improving quality of life (QoL) in patients with advanced PD. Methods: A systematic literature review was conducted for randomized controlled trials (RCTs), observational and interventional studies from January 2003 to September 2019. Data extracted at baseline and 6 months were off-time, as reported by diary or Unified Parkinson’s Disease Rating Scale Part IV item 39, and QoL, as reported by Parkinson’s Disease Questionnaire (PDQ-39/PDQ-8). Bayesian NMA was performed to estimate pooled treatment effect sizes and to rank treatments in order of effectiveness. Results: A total of 22 studies fulfilled the inclusion criteria (n = 2063 patients): four RCTs, and 16 single-armed, one 2-armed and one 3-armed prospective studies. Baseline mean age was between 55.5–70.9 years, duration of PD was 9.1–15.3 years, off-time ranged from 5.4 to 8.7 h/day in 9 studies, and PDQ scores ranged from 28.8 to 67.0 in 19 studies. Levodopa/carbidopa intestinal gel and DBS demonstrated significantly greater improvement in off-time and QoL at 6 months compared with CSAI and BMT (p < 0.05). There was no significant difference in the effects of LCIG and DBS, but DBS was ranked first for reduction in off-time, and LCIG was ranked first for improvement in QoL. Conclusions: This NMA found that LCIG and DBS were associated with superior improvement in off-time and PD-related QoL compared with CSAI and BMT at 6 months after treatment initiation. This comparative effectiveness research may assist providers, patients, and caregivers in the selection of the optimal device-aided therapy.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Pahwa, RajeshUniversity of Kansas (author)
  • Odin, PerLund University,Lunds universitet,Restorative Parkinson Unit,Forskargrupper vid Lunds universitet,Lund University Research Groups(Swepub:lu)med-poi (author)
  • Isaacson, Stuart H. (author)
  • Merola, AristideOhio State University (author)
  • Wang, LinJohns Hopkins Bloomberg School of Public Health,AbbVie Inc. (author)
  • Kandukuri, Prasanna L.AbbVie Inc. (author)
  • Alobaidi, AliAbbVie Inc.,University of Illinois at Chicago (author)
  • Yan, Connie H.University of Illinois at Chicago,AbbVie Inc. (author)
  • Bao, YanjunAbbVie Inc. (author)
  • Zadikoff, CindyAbbVie Inc. (author)
  • Parra, Juan CarlosAbbVie Inc. (author)
  • Bergmann, LarsAbbVie Inc. (author)
  • Chaudhuri, K. RayKing's College Hospital (author)
  • University of PadovaUniversity of Kansas (creator_code:org_t)

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  • In:CNS Drugs: Springer Science and Business Media LLC36:12, s. 1269-12831172-70471179-1934

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