Efficacy and safety of levodopa/benserazide combined with pramipexole in Parkinson’s disease:a meta-analysis

Objective To systematically evaluate the efficacy and safety of levodopa/benserazide combined with pramipexole in the treatment of Parkinson's disease(PD). Methods Randomised control trials(RCTs) of levodopa/benserazide combined with pramipexole for treating PD patients were searched from computerised databases, including PubMed, Cochrane Library, Chinese National Knowledge Infrastructure database(CNKI), VIP database for chinese technical periodical(VIP) and Wanfang Data. According to the included and excluded criterias, Meta-analysis was performed using Review Manager 5.3 software. Results Thirty trials with 3 041 patients were included. The Meta-analysis showed that compared with levodopa/benserazide alone, levodopa/benserazide combined with pramipexole could significantly improve the overall efficacy of clinical treatment [OR=5.05, 95% CI:(3.75, 6.78), P<0.01], at the same time, decrease the scores of UPDRS total [MD=-7.31, 95% CI:(-9.74,-4.89), P<0.01]. UPDRS part Ⅱ [MD=-2.23, 95% CI:(-3.17,-1.30), P<0.01] and UPDRS part Ⅲ [MD=-4.88, 95% CI:(-6.01,-3.74), P<0.01]. The results show that levodopa/benserazide combined with pramipexole significantly improved the overall of PD, quality of life and motor symptoms. Safety analysis showed that the incidence of adverse reactions such as nausea and vomiting, hypotension, dizziness, drowsiness and insomnia in patients of levodopa/benserazide combined with pramipexole group were not decreased compared with that in levodopa/benserazide alone(all P>0.05). However, the incidence of hallucination was increased in the combination group [OR=4.03, 95% CI:(1.37, 11.87), P=0.01], and the difference was statistically significant. Conclusion The treatment of levodopa/benserazide combined with pramipexole for PD has better curative effect, which can significantly improve the UDPRS score of patients, and the safety is reliable.