Pramipexole or levodopa treatment has been suggested as a therapeutic method for Parkinson disease. Nonetheless, the combined effects of 2 drugs for Parkinson disease patients are not completely understood.The aim of this systematic review was to evaluate the clinical efficacy and safety of Pramipexole plus levodopa combination therapy in the treatment of Parkinson disease compared to that of levodopaL monotherapy, in order to confer a reference for clinical practice.
Randomized controlled trials of Pramipexole plus levodopa for Parkinson disease published up to April, 2020 were retrieved. Standardized mean difference, odds ratio, and 95% confidence interval were calculated and heterogeneity was measured with the I2 test. Sensitivity analysis was also carried out. The outcomes of interest were as follows: the efficacy, unified Parkinson disease rating scale scores, Hamilton depression rating scale score or adverse events.
Twenty-four RCTs with 2171 participants were included. Clinical efficacy of Pramipexole plus levodopa combination therapy was significantly better than levodopa monotherapy.
The Hamilton depression rating scale score showed significant decrease in the Pramipexole plus levodopa combination therapy compared to L monotherapy. In contrast to levodopa monotherapy, Pramipexole plus levodopa combination therapy reduced the number of any adverse events obviously in Parkinson disease patients.
Moreover, the safety profile of Pramipexole plus levodopa combination therapy was found to be better than that of levodopa monotherapy. Further well-designed, multicenter RCTs are needed to confirm the findings of this systematic review of the literature of the field.