Safety and Efficacy of Rasagiline in Addition to Levodopa for the Treatment of Idiopathic Parkinson's Disease: A Meta-Analysis of Randomised Controlled Trials

Background: To assess the safety and efficacy of rasagiline for the treatment of Parkinson's disease (PD) among individuals currently receiving levodopa. Methods: A systematic literature search was conducted to identify randomised controlled trials (RCT) comparing rasagiline with placebo/no treatment in individuals with PD currently receiving levodopa. Outcome measures included improvement in motor functions; symptomatic improvement; improvement in quality of life; adverse effects. Random-effect meta-analytical techniques were conducted for the outcome measure and subgroup analyses. Results: Three RCTs were included (n = 1002). The results showed significantly greater improvements in daily 'on' time without dyskinesia in levodopa-treated participants with idiopathic PD receiving 1 mg/day rasagiline compared to placebo (n = 712,2 RCTs, MD 0.80, Cl 0.45 to 1.15; p <0.00001), and significantly greater improvements in Unified Parkinson's Disease Rating Scale motor performance scores during 'on' time in participants receiving 0.5-1 mg/day rasagiline (0.5 mg/day: n = 282, MD -2.91, Cl -4.59 to -1.23; p = 0.0007; 1 mg/day: n = 712,2 RCTs, MD -2.91, Cl -4.02 to -1.80; p < 0.00001). There were no significant differences in adverse effects. Conclusion: 0.5 to 1 mg/day rasagiline in addition to levodopa is a safe and well-tolerated combination therapy for individuals with Parkinson's disease. (C) 2014 S. Karger AG, Basel