Objective: The aim of this meta-analysis was to provide strong evidence for the main and side effects of istradefylline on patients with Parkinson’s disease.

Background: Adenosine A2A receptor antagonist is alternative option to treat Parkinson’s disease. Several randomized placebo controlled studies tested the effect of istradefylline, A2A receptor antagonist, and more robust evidence has been required.

Methods: After systematic literature search, we calculated standardized mean difference and pooled risk ratio for continuous and dichotomous variables, respectively. Further, sensitivity analyses were performed to confirm the effect estimated by meta-analyses. Publication bias was assessed by funnel plot and deviation of intercept.

Results: Six studies satisfied our inclusion criteria. Istradefylline 40mg/day improved both off time and motor symptoms of Parkinson’s disease with homogeneous studies. Istradefylline 20mg/day improved both off time and motor symptoms, but heterogeneity was found in the analysis of the former among studies. There was significant effect of istradefylline on dyskinesia with homogeneous studies. Publication bias, however, was observed in the comparison of dyskinesia. Other adverse events showed no significant difference.

Conclusions: The present meta-analysis suggested that istradefylline 40mg/day could alleviate off time and motor symptoms derived from Parkinson’s disease. Dyskinesia, however, might be worsened, which was affected by publication bias.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/istradefylline-improves-motor-symptoms-in-parkinsons-disease-a-meta-analysis/