Parkinson’s Disease

Review Article

A Systematic Review and Meta-Analysis of the Efficacy and Safety of Rasagiline or Pramipexole in the Treatment of Early Parkinson’s Disease

Table 4

Change in UPDRS scores seen following pramipexole administration.


Change in UPDRS
Study, year	Time of assessment (from the start of the study)	Treatment	Part II	Part III	Total	Comments

Barone et al. 2010	5 wk.	PBO	NR	−1.0 ± 1.0	NR	UPDRS score had different number of patients PBO (n = 148), PPX (n = 139)
	5 wk.	PPX	NR	−4.1 ± 1.0	NR
	12 wk.	PBO	−1.2 ± 0.3	−2.2 ± 0.5	NR
	12 wk.	PPX	−2.4 ± 0.3	−4.4 ± 0.3	NR

Hauser et al. 2010	18 wk.	PBO	0.0 ± 0.5	−2.7 ± 1.0	NR	UPDRS scores had different number of patients PBO (n = 50), ER (n = 102), IR (n = 101). Levodopa data censored in the scores
		PPX ER	−1.5 ± 0.4	−5.9 ± 0.9	NR
		PPX IR	−1.8 ± 0.4	−5.9 ± 0.8	NR

Parkinson Study Group 2000^a	23.5 mo.	PPX	1.1 ± 4.5	3.4 ± 8.6	4.5 ± 12.7	Values are reported from the whole study population (n = 301). Negative values indicated worsening and positive values indicated improvement
Parkinson Study Group 2000^a	23.5 mo.	LD	2.2 ± 3.2	7.3 ± 8.6	9.2 ± 10.8
Parkinson Study Group 2004	48 mo.	PPX	−1.7 ± 5.4	−1.3 ± 13.3	−3.2 ± 17.3
Parkinson Study Group 2004	48 mo.	LD	−0.5 ± 4.7	3.4 ± 12.3	2.0 ± 15.4

Kieburtz et al. 1997	10 wk.	PBO	NR	NR	−0.9 ± 9.1	The score in the parenthesis: secondary analysis of changes from baseline to 10 weeks in total UPDRS score. Difference between treatment group mean and placebo group mean. for all doses
		PPX 1.5	NR	NR	−6.3 ± 9.0 (-5.24 (−8.95 to −1.54))
		PPX 3.0	NR	NR	−5.9 ± 6.4 (-5.08 (−8.86 to −1.29))
		PPX 4.5	NR	NR	−6.5 ± 8.2 (-5.86 (−9.59 to −2.13))
		PPX 6.0	NR	NR	−7.0 ± 8.1 (-5.24 (−8.96 to −1.53))

Poewe et al. 2011	33 wk.	PBO	−0.2 (−0.9 to 0.4)	−1.1 (−2.5 to 0.3)	NR	N = 103 (PBO), N = 213 (ER), N = 207 (IR)
		PPX ER	−2.1 (−2.5 to −1.6)	−6.1 (−7.1 to −5.1)	NR
		PPX IR	−2.4 (−2.8 to −1.9)	−6.4 (−7.4 to −5.4)	NR

Schapira et al. 2013	6 to 9 mo.^b	PBO	1.5 ± 0.2	2.7 ± 0.5	4.3 ± 0.6	N = 200 (PBO), N = 210 or 211 depending on time points (PPX)
Schapira et al. 2013	6 to 9 mo.^b	PPX	0.4 ± 0.2 −1.1 (−1.7 to −0.5)	−0.6 ± 0.5 −3.3 (−4.5 to −2.2)	−0.5 ± 0.6 −4.8 (−6.3 to −3.2)

Shannon et al. 1997	31 wk.	PBO	0.4	1.3	NR	—
Shannon et al. 1997	31 wk.	PPX	−1.8	−4.7	NR	—

Thomas et al. 2006	24 mo.	PPX	NR	11.9 ± 2.3	NR	—
Thomas et al. 2006	24 mo.	RR	NR	12.6 ± 2.8	NR	—

Wong et al. 2003	15 wk. without LD	PBO	−2.2 ± 0.6	−1.3 ± 1.6	NR	Patients without levodopa (n = 22 PBO), (n = 21, PPX)
	15 wk. without LD	PPX	−2.9 ± 0.6	−11.5 ± 1.6	NR	Patients without levodopa (n = 22 PBO), (n = 21, PPX)
	15 wk. with LD	PBO	−0.5 ± 0.5	−0.6 ± 1.1	NR	Patients with levodopa (n = 54 PBO), (n = 50, PPX)
	15 wk. with LD	PPX	−3.2 ± 0.5	−7.2 ± 1.3	NR	Patients with levodopa (n = 54 PBO), (n = 50, PPX)

Values are reported as mean ± standard deviation. ER = extended release, IR = immediate release, LD = levodopa, mo = months, NR = not reported, PBO = placebo PPX = pramipexole, UPDRS = the unified Parkinson’s disease rating scale, RR = ropinirole, and wk = weeks. ^aParkinson Study Group [34] reported the first 2 yr. of the study and Parkinson Study Group [35] reported results at the end of the 4-year study. ^bPatients were assigned to the pramipexole group at 9 months or as early as 6 months, if the patients expressed inability to tolerate PD symptoms. Statistically significant results are highlighted using bold text.