Search

The objective of this meta-analysis was to evaluate the effects of coenzyme Q10 (CoQ10) for the treatment of Parkinson's disease (PD) patients in order to arrive at qualitative and quantitative conclusions about the efficacy of CoQ10. Databases searched included PubMed, Google scholar, CNKI, Wan-Fang, and the Cochrane Library from inception to March 2016. We only included sham-controlled, randomized clinical trials of CoQ10 intervention for motor dysfunction in patients with PD. Relevant measures were extracted independently by two investigators. Weighted mean differences (WMD) were calculated with random-effects models. Eight studies with a total of 899 patients were included. Random-effects analysis revealed a pooled WMD of 1.02, indicating no significant difference when CoQ10 treatment compared with placebo in terms of UPDRS part 3 (p = 0.54). Meanwhile, the effect size of UPDRS part 1, UPDRS part 2, and total UPDRS scores were similar in CoQ10 group with in placebo group (p > 0.05). Moreover, we found CoQ10 was well tolerated compared with placebo group. Subgroup analysis showed that the effect size of CoQ10 in monocentric studies was larger than in multicenter studies. Using the GRADE criteria, we characterized the quality of evidence presented in this meta-analysis as moderate to high level. The current meta-analysis provided evidence that CoQ10 was safe and well tolerated in participants with PD and no superior to placebo in terms of motor symptoms. According to these results, we cannot recommend CoQ10 for the routine treatment of PD right now. [ABSTRACT FROM AUTHOR]

To assess the long-term use of l-dopa alone vs l-dopa-sparing therapy, as initial treatment, provides the most efficient long-term control of symptoms and best quality of life for people with early Parkinson's disease (PD). PubMed; Google scholar; Cochrane Central Register of Controlled Trials and the Web of Science were searched for randomised, placebo-controlled trials (RCTs) on l-dopa alone and l-dopa sparing as initial treatment in early PD patients. We used a random effects model rather than a fixed effects model because of this takes into account heterogeneity between multi-studies. Eleven RCTs were included. The results showed that l-dopa alone could evidently improve the UPDRS part I ( p = 0.005), part II ( p < 0.0001), part III ( p < 0.0001) and UPDRS total score ( p = 0.004) compared with l-dopa-sparing therapy in PD patients. Meanwhile, a reduced risk of dyskinesia ( p < 0.0001, RR = 1.88, 95 % CI 1. 37-2.59) and wearing-off phenomenon ( p < 0.00001, RR = 1.36, 95 % CI 1. 20-1.55) in patients treated initially with l-dopa-sparing therapy compared to l-dopa has been consistently reported. What is more, we found more patients on a l-dopa-sparing therapy were more than triple as likely to discontinue treatment prematurely due to adverse events than l-dopa treatment patients (43.7 vs 15.8 %). l-Dopa alone is the most effective medication available for treating the motor symptoms of PD patients, despite the greater incidence of involuntary movements. Meanwhile, more patients on dopamine agonists or MAOBI were more likely to discontinue treatment prematurely than l-dopa alone treatment patients within the long follow-up period. [ABSTRACT FROM AUTHOR]