Safety and Efficacy of Levetiracetam for the Management of Levodopa- Induced Dyskinesia in Patients with Parkinson's Disease: A Systematic Review.


Journal

CNS & neurological disorders drug targets
ISSN: 1996-3181
Titre abrégé: CNS Neurol Disord Drug Targets
Pays: United Arab Emirates
ID NLM: 101269155

Informations de publication

Date de publication:
2019
Historique:
received: 08 01 2019
revised: 28 02 2019
accepted: 07 03 2019
pubmed: 15 3 2019
medline: 6 8 2020
entrez: 15 3 2019
Statut: ppublish

Résumé

Levetiracetam, a novel antiepileptic drug, has shown antidyskinetic effects in experimental animal models of Parkinson's disease (PD). The tolerability and efficacy of levetiracetam in reducing the levodopa-induced dyskinesia (LID) in PD patients have not been established. Therefore, this study aims to synthesize evidence from published prospective clinical trials about the efficacy of levetiracetam for the management of LID in PD patients. We followed the PRISMA statement guidelines during the preparation of this systematic review. A computer literature search of PubMed, EBSCO, Scopus, MEDLINE, and the web of science was carried out. We selected prospective clinical trials assessing the anti-dyskinetic efficacy of levetiracetam for treating LID in patients with PD. The Abnormal Involuntary Movement Scale (AIMS), Clinical Global Impression Score (GCI), UPDRS III, and UPDRS IV were considered as the primary outcome measures; their data were extracted and reviewed. Our review included seven clinical trials with a total of 150 patients. Of them, three studies were randomized controlled trials, and the remaining were open-label single arm trials. Four studies reported poor tolerability of the levetiracetam with mild anti-dyskinetic effects. Levetiracetam slightly improved the UPDRS-IV and AIMS scores with small effect size. In the remaining three studies, levetiracetam failed to exhibit any anti-dyskinetic effects. Current evidence does not support the efficacy of the levetiracetam for treating LID in PD patients, however, due to the limited number of published randomized control trials (RCTs), further RCTs are required.

Sections du résumé

BACKGROUND
Levetiracetam, a novel antiepileptic drug, has shown antidyskinetic effects in experimental animal models of Parkinson's disease (PD). The tolerability and efficacy of levetiracetam in reducing the levodopa-induced dyskinesia (LID) in PD patients have not been established. Therefore, this study aims to synthesize evidence from published prospective clinical trials about the efficacy of levetiracetam for the management of LID in PD patients.
METHODS
We followed the PRISMA statement guidelines during the preparation of this systematic review. A computer literature search of PubMed, EBSCO, Scopus, MEDLINE, and the web of science was carried out. We selected prospective clinical trials assessing the anti-dyskinetic efficacy of levetiracetam for treating LID in patients with PD. The Abnormal Involuntary Movement Scale (AIMS), Clinical Global Impression Score (GCI), UPDRS III, and UPDRS IV were considered as the primary outcome measures; their data were extracted and reviewed.
RESULTS
Our review included seven clinical trials with a total of 150 patients. Of them, three studies were randomized controlled trials, and the remaining were open-label single arm trials. Four studies reported poor tolerability of the levetiracetam with mild anti-dyskinetic effects. Levetiracetam slightly improved the UPDRS-IV and AIMS scores with small effect size. In the remaining three studies, levetiracetam failed to exhibit any anti-dyskinetic effects.
CONCLUSION
Current evidence does not support the efficacy of the levetiracetam for treating LID in PD patients, however, due to the limited number of published randomized control trials (RCTs), further RCTs are required.

Identifiants

pubmed: 30868968
pii: CNSNDDT-EPUB-97313
doi: 10.2174/1871527318666190314101314
doi:

Substances chimiques

Anticonvulsants 0
Antiparkinson Agents 0
Levetiracetam 44YRR34555
Levodopa 46627O600J

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

317-325

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Auteurs

Mahmoud A Ebada (MA)

Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medical Research Group of Egypt.

Souad Alkanj (S)

Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medical Research Group of Egypt.

Mohamed Ebada (M)

Al-Ahrar Teaching Hospital, Kafr El-Ahrar, Egypt.

Ahmed H Abdelkarim (AH)

Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medical Research Group of Egypt.

Ahmed Diab (A)

Medical Research Group of Egypt.
Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Mohamed A E Aziz (MAE)

Medical Research Group of Egypt.
Omr Shahin Mental Hospital, Egypt.

Ahmed M Soliman (AM)

Medical Research Group of Egypt.
Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Notila Fayed (N)

Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medical Research Group of Egypt.

Eshak I Bahbah (EI)

Medical Research Group of Egypt.
Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Ahmed Negida (A)

Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Medical Research Group of Egypt.

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Classifications MeSH