背景:帕金森病(PD)常忽略疼痛,尽管它影响大多数PD患者。虽然PD疼痛的机制仍在研究中,各种药理学,介入,并为缓解疼痛提供了替代治疗方案。Safinamide,最近批准的PD药物,在改善PD患者疼痛方面显示出有希望的结果。一些临床研究报告了接受safinamide治疗的PD患者疼痛评分的变化,但是这些还没有得到系统的总结。因此,我们的主要目标是对相关研究进行系统回顾和统计分析.
方法:使用四个数据库对研究进行了系统搜索:Pubmed,科克伦图书馆,谷歌学者,还有Scopus.纳入的9项随机对照试验没有为荟萃分析提供足够的数据;因此,我们进行了定性系统回顾。
结果:我们的结果表明,每日剂量为100mg的沙芬酰胺比50mg的沙芬酰胺更有效地治疗PD疼痛。此外,与其他PD疼痛类型相比,使用沙芬酰胺治疗时,波动相关疼痛和水肿引起的疼痛减轻更为一致.我们还试图提出safinamide对大脑疼痛处理的作用机制,这应该在未来的研究中更详细地探讨。
结论:临床证据表明,沙芬酰胺可能对经历波动相关疼痛和水肿疼痛的PD患者特别有益,因为与其他类型的疼痛相比,这些亚型的疼痛表现出更大的改善。根据纳入研究的结果,safinamide似乎可以减轻整体疼痛负担。然而,缺乏足够的数据进行荟萃分析,这凸显了未来研究需要报告平均疼痛评分及其标准差.
BACKGROUND: Pain is often neglected in Parkinson\'s disease (PD), although it impacts most PD patients. While the mechanism of pain in PD is still being studied, various pharmacological, interventional, and alternative treatment options have been offered for pain relief.
Safinamide, a recently approved drug for PD, has shown promising results in improving pain in patients with PD. Several clinical studies report changes in pain scores in PD patients treated with
safinamide, but these have not been systematically summarized. Therefore, our main goal was to perform a systematic review and statistical analysis of relevant studies.
METHODS: A systematic search of studies was conducted using four databases: Pubmed, Cochrane Library, Google Scholar, and Scopus. The nine included randomized controlled trials did not provide sufficient data for a meta-analysis; therefore, we conducted a qualitative systematic review.
RESULTS: Our results suggest that
safinamide at a daily dose of 100mg is more effective for treating PD pain than that of 50mg. Moreover, the reduction in fluctuation-related pain and pain from edema was more consistent when treated with safinamide compared to other PD pain types. We also attempted to suggest a mechanism of action for safinamide on pain processing in the brain, which should be explored in more detail in future studies.
CONCLUSIONS: Clinical evidence suggests that
safinamide may be particularly beneficial for PD patients experiencing fluctuation-related pain and pain from edema, as these subtypes of pain showed greater improvement compared to other types of pain. Based on the findings of the included studies,
safinamide appears to relieve the overall pain burden. However, the lack of sufficient data for conducting a meta-analysis highlights the need for future studies to report mean pain scores and their standard deviations.