Evidence map›Paper›PMID 39805118›Full record

SynthesisClinical neuropharmacology

Comparative Safety of Istradefylline Among Parkinson Disease Adjunctive Therapies: A Systematic Review and Meta-analysis of Randomized Controlled Studies.

Yasar Torres-Yaghi, Joyce Qian, Hannah Cummings, Hiroo Shimoda, Satoru Ito, Sarah Batson, Stephen Mitchell, Fernando Pagan

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical neuropharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yasar Torres-YaghiMedStar Georgetown University Hospital, Washington, DC.
Joyce QianKyowa Kirin, Inc., Princeton, NJ.ORCID 0000-0002-1368-1576
Hannah CummingsKyowa Kirin, Inc., Princeton, NJ.
Hiroo ShimodaKyowa Kirin Co., Ltd., Tokyo, Japan.
Satoru Ito
Sarah BatsonMtech Access, Bicester, Oxfordshire, United Kingdom.
Stephen MitchellMtech Access, Bicester, Oxfordshire, United Kingdom.
Fernando PaganMedStar Georgetown University Hospital, Washington, DC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAdjunctive therapies to treat OFF episodes resulting from long-term levodopa treatment in Parkinson disease (PD) are hampered by safety and tolerability issues. Istradefylline offers an alternative mechanism (adenosine A2A receptor antagonist) and therefore potentially improved tolerability.

methodsA systematic review of PD adjuncts published in 2011 was updated to include randomized controlled trials published from January 1, 2010-April 15, 2019. Pairwise meta-analyses were updated, and Bucher indirect comparisons were used to generate estimates of relative safety, presented as odds ratio (OR) and 95% confidence interval (CI) for comparators versus istradefylline.

resultsFifty-seven randomized controlled trials involving 11,517 patients were included in the meta-analysis. Relative to istradefylline, dopamine agonists and catechol-O-methyl transferase (COMT) inhibitors had statistically significant higher odds of dyskinesia and somnolence. Monoamine oxidase-B inhibitors had significantly higher odds of hypotension. Amantadine extended-release (ER) had statistically significant higher odds of hallucination, orthostatic hypotension, insomnia, and withdrawals due to adverse events. All interventions combined had significantly higher odds of dyskinesia versus istradefylline 20 mg and somnolence versus istradefylline 40 mg. Considering overall incidence of adverse events, COMT inhibitors and amantadine ER had statistically significant higher odds versus both istradefylline doses (COMT versus istradefylline 40 mg, OR: 1.33; 95% CI: 1.03, 1.75; versus istradefylline 20 mg, OR: 1.32; 95% CI: 1.01, 1.72; amantadine ER versus istradefylline 40 mg, OR: 3.45; 95% CI: 1.85, 6.25; versus istradefylline 20 mg, OR: 3.33; 95% CI: 1.82, 6.25).

conclusionIstradefylline was associated with a generally favorable safety profile relative to other adjunct medications in this study.

Indexed as

Adenosine A2 Receptor AntagonistsAntiparkinson AgentsParkinson DiseasePurinesRandomized Controlled Trials as TopicCatechol O-Methyltransferase InhibitorsDopamine AgonistsDrug Therapy, CombinationHumansAdenosine A2 Receptor AntagonistsAntiparkinson AgentsCatechol O-Methyltransferase InhibitorsDopamine AgonistsistradefyllinePurines

Identifiers

PMID39805118
PMCPMC11913241

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.