Background: Clinical and epidemiological studies suggest that two of the most common geriatric diseases, type 2 diabetes and Parkinson’s disease (PD), are linked. These studies notably suggest that treatment of insulin resistance in type 2 diabetes may beneficially modify the pathophysiology of PD and help to maintain motor and nonmotor function. In this meta-analysis, we evaluate the efficacy of new antidiabetic agents in the treatment of PD. Methods: We systematically searched PubMed, Medline, ProQuest, ScienceDirect, ClinicalKey, and Cochrane Library from the date of their inception until 15 March 2020. Multiple efficacy parameters were compared between treatment groups. The results are expressed as mean differences with 95% confidence intervals (CIs) in a random-effects model. Results: A meta-analysis of the data extracted from three randomized control trials revealed that treatment with exenatide yielded significant improvements in scores on the Unified Parkinson’s Disease Rating Scale Part I (UPDRS-I) (−0.438, 95% CI, −0.828 to −0.048, p = 0.028), UPDRS Part IV (UPDRS-IV) (−0.421, 95% CI, −0.811 to −0.032, p = 0.034) and the Mattis Dementia Rating Scale (MDRS) (−0.595, 95% CI, −1.038 to −0.151, p = 0.009). At the 12-month follow-up, the UPDRS Part III (UPDRS-III) scores in the off-medication phase revealed significant improvements in patients using exenatide (−0.729; 95% CI, −1.233 to −0.225, p = 0.005). Treatment with pioglitazone did not yield significant improvements in UPDRS, MDRS, or Parkinson’s Disease Questionnaire scores. Conclusion: This meta-analysis suggests that exenatide use is associated with the alleviation of cognitive, motor and nonmotor symptoms. However, long-term studies with a large sample size of patients with PD of varying severity are required.

中文翻译：

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治疗帕金森氏病的抗糖尿病药物：一项荟萃分析。

背景：临床和流行病学研究表明，两种最常见的老年病，即2型糖尿病和帕金森氏病（PD）相互关联。这些研究尤其表明，治疗2型糖尿病的胰岛素抵抗可能有益地改变PD的病理生理，并有助于维持运动和非运动功能。在这项荟萃分析中，我们评估了新型抗糖尿病药在PD治疗中的功效。方法：我们从开始到2020年3月15日，系统搜索了PubMed，Medline，ProQuest，ScienceDirect，ClinicalKey和Cochrane库。比较了各治疗组之间的多个功效参数。结果表示为随机效应模型中具有95％置信区间（CI）的平均差异。结果：对从三项随机对照试验中提取的数据进行的荟萃分析显示，艾塞那肽治疗显着改善了帕金森病综合评分量表第I部分（UPDRS-I）（-0.438、95％CI，-0.828至-0.048，p = 0.028），UPDRS第IV部分（UPDRS-IV）（-0.421，95％CI，-0.811至-0.032，p = 0.034）和Mattis痴呆症评分量表（MDRS）（-0.595，95％CI ，-1.038至-0.151，p = 0.009）。在12个月的随访中，非药物治疗阶段的UPDRS第III部分（UPDRS-III）评分显示，使用艾塞那肽治疗的患者显着改善（-0.729; 95％CI，-1.233至-0.225，p= 0.005）。吡格列酮治疗对UPDRS，MDRS或帕金森氏病问卷的得分没有明显改善。结论：这项荟萃分析表明艾塞那肽的使用与认知，运动和非运动症状的缓解有关。但是，需要对具有不同严重程度的PD患者的大量样本进行长期研究。