Abstract | BACKGROUND: OBJECTIVES: SEARCH STRATEGY: Electronic searches of MEDLINE, EMBASE and the Cochrane Controlled Trials Register. Handsearching of the neurology literature as part of the Cochrane Movement Disorders Group's strategy. Examination of the reference lists of identified studies and other reviews. Contact with SmithKline Beecham. SELECTION CRITERIA: DATA COLLECTION AND ANALYSIS: Data was abstracted independently by the authors and differences settled by discussion. The outcome measures used included Parkinson's disease rating scales, levodopa dosage, 'off' time measurements and the frequency of withdrawals and adverse events. MAIN RESULTS: In the 3 trials identified, no significant differences between ropinirole and bromocriptine were found in off time reduction, dyskinesia as an adverse event, motor impairment and disability, or levodopa dose reduction. Withdrawal rates and adverse event frequency were similar with the two agents apart from significantly less nausea with ropinirole (odds ratio 0.50; 0.29, 0.84 95% CI; p =0.01). REVIEWER'S CONCLUSIONS:
Ropinirole is at least as good as bromocriptine in patients with Parkinson's disease with motor complications in terms of improving off time and reducing levodopa dose, without increasing adverse events including dyskinesia. However, these comparitor studies may have been underpowered to detect clinically meaningful differences between the agonists. Further, much larger, phase IV studies are required to examine the efficacy, effectiveness, and safety of all of the dopamine agonists as adjuvant therapy in Parkinson's disease.
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Authors | C E Clarke, K H Deane |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 1
Pg. CD001517
( 2001)
ISSN: 1469-493X [Electronic] England |
PMID | 11279719
(Publication Type: Journal Article, Review, Systematic Review)
|
Chemical References |
- Antiparkinson Agents
- Dopamine Agonists
- Indoles
- Bromocriptine
- Levodopa
|
Topics |
- Antiparkinson Agents
(adverse effects)
- Bromocriptine
(therapeutic use)
- Dopamine Agonists
(therapeutic use)
- Dyskinesias
(drug therapy, etiology)
- Humans
- Indoles
(therapeutic use)
- Levodopa
(adverse effects)
- Parkinson Disease
(drug therapy)
- Randomized Controlled Trials as Topic
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