Rasagiline for Parkinson's disease: A meta-analysis

Objective: To systematically review the effectiveness and safety of rasagiline for Parkinson's disease. Methods: Databases including The Cochrane Library (Issue 3, 2013), Web of Science, MEDLINE (Ovid), PubMed, CBM, CNKI, WanFang Data and VIP were electronically searched from inception to March 2013 for randomized controlled trials (RCTs) on rasagiline for Parkinson's disease. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of included studies. Meta-analysis was performed using RevMan 5.1 software. Results: In total, 6 studies involving 2 865 patients were included. The results of meta-analyses indicated that, compared with placebo, rasagiline 2 mg/d and 1 mg/d was significantly effective (MD= -3.16, 95%CI -3.21 to -3.11, P<0.000 01; MD= -3.01, 95%CI -3.06 to -2.96, P<0.000 01). Rasagiline 1 mg/d was more effective than rasagiline 2 mg/d in the treatment of early PD (MD= -0.65, 95%CI -0.73 to -0.57, P<0.000 01). There was no significant difference between rasagiline and placebo in the incidences of nausea, headache, and dizziness (nausea: OR=0.72, 95%CI 0.49 to 1.07, P=0.60; headache: OR=1.02, 95%CI 0.70 to 1.49, P=0.91; dizziness: OR=0.87, 95%CI 0.49 to 1.55, P=0.35). Conclusion: Rasagiline is effective for early Parkinson's disease, and the dosage 1 mg/d is better than 2 mg/d based on current limited evidence. Rasagiline has a good tolerance and safety. Due to the limited quantity of the included studies and the evidence with limited strength, further high-quality RCTs are needed to verify the aforementioned conclusion. © 2014 Editorial Board of Chin J Evid-based Med.