Lisuride versus bromocriptine for levodopa-induced complications in Parkinson's disease
Editorial Group: Cochrane Movement Disorders Group
Published Online: 25 JAN 1999
Assessed as up-to-date: 24 NOV 1998
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Clarke C E, Speller J M, Clarke CE. Lisuride versus bromocriptine for levodopa-induced complications in Parkinson's disease. Cochrane Database of Systematic Reviews 1999, Issue 1. Art. No.: CD001514. DOI: 10.1002/14651858.CD001514.
- Publication Status: Edited (no change to conclusions)
- Published Online: 25 JAN 1999
Long-term levodopa therapy in Parkinson's disease is associated with the development of motor complications including abnormal involuntary movements and a shortening response to each dose (wearing off phenomenon). It is thought that dopamine agonists can reduce the duration of immobile off periods and the need for levodopa therapy whilst maintaining or improving motor impairments and only minimally increasing dopaminergic adverse events.
To compare the efficacy and safety of adjunct lisuride therapy versus bromocriptine in patients with Parkinson's disease, already established on levodopa and suffering the long-term complications of therapy.
Electronic searches of MEDLINE, EMBASE and the Cochrane Controlled Trials Register. Handsearching of the neurology literature as part of the Cochrane Movement Disorders Group's strategy. Examination of the reference lists of identified studies and other reviews. Contact with Cambridge Laboratories, Roche Products Limited and Sandoz Limited.
Randomised controlled trials of lisuride versus bromocriptine in patients with a clinical diagnosis of idiopathic Parkinson's disease and long-term complications of levodopa therapy.
Data collection and analysis
Data was abstracted independently by each author and differences settled by discussion.
Only one randomised cross-over trial including 20 patients has compared lisuride with bromocriptine as adjunct therapy in Parkinson's disease. Both lisuride and bromocriptine improved motor fluctuations with no significant differences between the agonists. However, this conclusion is based on an unvalidated 4 point rating scale which could only record positive outcomes. This, combined with the small size of the trial, suggests that firm conclusions on motor fluctuations should not be drawn. Lisuride and bromocriptine produced similar benefits in parkinsonian impairments according to the Columbia Rating Scale. Adverse events were similar with the two agonists and no withdrawals were reported from either drug.
The small size of this study and other methodological problems do not allow any firm conclusions to be drawn regarding the efficacy and safety of lisuride compared with bromocriptine in advanced Parkinson's disease with motor complications.
對巴金森氏症採取長期使用的左多巴療法可能會導致運動相關的併發症, 包括不正常的非自主運動與每次投藥有效時間縮短等(消逝現象). 多巴胺促效劑可以減少病患無法活動的時間, 和在維持或改善運動功能的前提下, 減少患者對左多巴的需要, 且只會輕微的增加多巴胺性的副作用.
以電腦搜尋了MEDLINE, EMBASE以及the Cochrane Controlled Trials Register. 以人工方式搜尋了the Cochrane Movement Disorders Group strategy中部分的神經內科的文獻. 檢查了一些研究所列示的文獻以及文獻回顧的文章. 並與劍橋實驗室, Roche Products Limited 以及 Sandoz Limited聯絡
只有一個總共只包含了20個巴金森氏症患者的隨機交叉試驗，比較以lisuride與bromocriptine作為添加治療的療效., 總共只包含了20個巴金森氏症患者. 兩者皆可改善運動功能波動的現象且兩者間的效果沒有顯著差異. 然而, 這個結論是立基於一未受驗證的只有分成四點分數的評分量表, 這種表格僅能記錄出正向分數, 再加上過小的樣本數, 顯示這樣的結論是不適合被採信的. 根據Columbia Rating Scale, Lisuride和bromocriptine對於巴金森氏症的症狀有相似的助益. 副作用亦相似且並沒有患者因此停藥.
針對已有運動相關併發症的晚期巴金森氏症患者, 關於lisuride與bromocriptine之間安全性與效度的比較, 由於本篇研究的規模太小, 且有統計學上的問題, 導致無法得出確切的結論.
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。