Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jul 3;17(13):4805.
doi: 10.3390/ijerph17134805.

Antidiabetic Agents for Treatment of Parkinson's Disease: A Meta-Analysis

Shu-Yi Wang  1 , Shey-Lin Wu  2 , Ta-Cheng Chen  2 , Chieh-Sen Chuang  2   3
Affiliations
Review

Antidiabetic Agents for Treatment of Parkinson's Disease: A Meta-Analysis

Shu-Yi Wang et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: Parkinson’s disease; Thiazolidinedione; antidiabetic agent; glucagon-like peptide 1; meta-analysis.

PubMed Disclaimer

Conflict of interest statement

The authors report no financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Forest plot of effect sizes for UPDRS-I (a) (significant improvement on exenatide: −0.438, p = 0.028), UPDRS-II (b), UPDRS-III during the on-medication phase (c), UPDRS-III at the 12-month follow-up during the off-medication phase (d) (significant improvement on exenatide: −0.729, p = 0.005), and UPDRS-IV (e) (significant improvement on exenatide: −0.421, p = 0.034). UPDRS: Unified Parkinson’s Disease Rating Scale.
Figure 2
Figure 2
Forest plot of effect sizes for UPDRS-I (a) (significant improvement on exenatide: −0.438, p = 0.028), UPDRS-II (b), UPDRS-III during the on-medication phase (c), UPDRS-III at the 12-month follow-up during the off-medication phase (d) (significant improvement on exenatide: −0.729, p = 0.005), and UPDRS-IV (e) (significant improvement on exenatide: −0.421, p = 0.034). UPDRS: Unified Parkinson’s Disease Rating Scale.
Figure 3
Figure 3
Forest plot of effect sizes for MDRS (a) (significant improvement on exenatide: −0.595, p = 0.009), and PDQ-39 (b). MDRS: Mattis Dementia Rating Scale, PDQ-39: Parkinson’s Disease Questionnaire.
Figure 4
Figure 4
Quality assessment for the risk of bias for each study included in this meta-analysis.
See this image and copyright information in PMC

References

    1. De Lau L.M., Breteler M.M. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5:525–535. doi: 10.1016/S1474-4422(06)70471-9. - DOI - PubMed
    1. Ascherio A., Schwarzschild M.A. The epidemiology of Parkinson’s disease: Risk factors and prevention. Lancet Neurol. 2016;15:1257–1272. doi: 10.1016/S1474-4422(16)30230-7. - DOI - PubMed
    1. Hu G., Jousilahti P., Bidel S., Antikainen R., Tuomilehto J. Type 2 diabetes and the risk of Parkinson’s disease. Diabetes Care. 2007;30:842–847. doi: 10.2337/dc06-2011. - DOI - PubMed
    1. Lima M.M., Targa A.D., Noseda A.C., Rodrigues L.S., Delattre A.M., Dos Santos F.V., Fortes M.H., Maturana M.J., Ferraz A.C. Does Parkinson’s disease and type-2 diabetes mellitus present common pathophysiological mechanisms and treatments? CNS Neurol. Disord. Drug Targets. 2014;13:418–428. doi: 10.2174/18715273113126660155. - DOI - PubMed
    1. Hogg E., Athreya K., Basile C., Tan E.E., Kaminski J., Tagliati M. High prevalence of undiagnosed insulin resistance in non-diabetic subjects with Parkinson’s disease. J. Parkinsons Dis. 2018;8:259–265. doi: 10.3233/JPD-181305. - DOI - PubMed