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Comparative Effecti...
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
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- Antonini, Angelo (författare)
- University of Padova
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- Pahwa, Rajesh (författare)
- University of Kansas
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- Odin, Per (författare)
- Lund University,Lunds universitet,Restorative Parkinson Unit,Forskargrupper vid Lunds universitet,Lund University Research Groups
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Isaacson, Stuart H. (författare)
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- Merola, Aristide (författare)
- Ohio State University
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- Wang, Lin (författare)
- AbbVie Inc.,Johns Hopkins Bloomberg School of Public Health
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- Kandukuri, Prasanna L. (författare)
- AbbVie Inc.
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- Alobaidi, Ali (författare)
- University of Illinois at Chicago,AbbVie Inc.
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- Yan, Connie H. (författare)
- AbbVie Inc.,University of Illinois at Chicago
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- Bao, Yanjun (författare)
- AbbVie Inc.
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- Zadikoff, Cindy (författare)
- AbbVie Inc.
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- Parra, Juan Carlos (författare)
- AbbVie Inc.
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- Bergmann, Lars (författare)
- AbbVie Inc.
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- Chaudhuri, K. Ray (författare)
- King's College Hospital
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(creator_code:org_t)
- 2022-11-21
- 2022
- Engelska 15 s.
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Ingår i: CNS Drugs. - : Springer Science and Business Media LLC. - 1172-7047 .- 1179-1934. ; 36:12, s. 1269-1283
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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Antonini, Angelo
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Pahwa, Rajesh
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Odin, Per
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Isaacson, Stuart ...
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Merola, Aristide
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Wang, Lin
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visa fler...
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Kandukuri, Prasa ...
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Alobaidi, Ali
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Yan, Connie H.
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Bao, Yanjun
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Zadikoff, Cindy
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Parra, Juan Carl ...
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Bergmann, Lars
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Chaudhuri, K. Ra ...
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visa färre...
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