Incidence of Augmentation in Primary Restless Legs Syndrome Patients May Not Be That High: Evidence From A Systematic Review and Meta-Analysis.
Incidence of Augmentation in Primary Restless Legs Syndrome Patients May Not Be That High: Evidence From A Systematic Review and Meta-Analysis.
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DOI：
10.1097/md.0000000000002504
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发表时间：
2016-01
期刊：
影响因子：
1.6
通讯作者：
Chang LY
中科院分区：
文献类型：
--
作者：
Liu GJ;Wu L;Wang SL;Ding L;Xu LL;Wang YF;Chang LY
补充数字内容可在文本中获得，增强是治疗期间原发性不宁腿综合征(RLS)的常见并发症；然而，其发生率仍不清楚。这项研究的目的是调查RLS治疗期间的增高率。计算机检索PubMed、Ovid、Embase、Wiley引文、科学网研究平台(包括SCHELO引文索引、Medline、韩国期刊数据库、科学网™核心文库)、Cochrane图书馆等6个数据库，筛选纳入试验的参考文献列表和近期发表的综述。随机对照试验和观察性研究，报告了在RLS治疗期间发生的增强事件。年龄大于18岁的原发RLS患者。没有关于干预类型的限制。三名研究人员独立提取和合并数据，以分析总样本和不同干预措施、治疗持续时间、药物方案和不同地理来源的患者亚组的扩大率。合并分析采用固定效应或随机效应模型。涉及11,543名参与者的60项研究表明，总体增强率为5.6%(95%可信区间为4.0-7.7)。长期治疗的增高率为6.1%(95%CI，4.1~9.1)，短期治疗的增高率为3.3%(95%CI，1.4~7.3)。此外，27.1%(95%可信区间，12.3~49.5)的左旋多巴治疗患者、6.0%(95%可信区间，4.1~8.8)的多巴胺激动剂治疗患者和0.9%(95%可信区间，0.2~3.3)服用普瑞巴林或加巴喷丁的患者发生扩张。在服用速释药物的患者中，7.2%(95%CI，5.0~10.3)的患者发生了增强，而在使用透皮贴剂的患者中，有1.7%(95%CI，0.6~5.0)发生了增强。主要的限制是没有根据药物剂量、性别、年龄和症状严重程度来评估增强率。在100名RLS患者中，大约有5-6人在治疗过程中出现了增大。
Supplemental Digital Content is available in the text Augmentation is a common complication of primary restless legs syndrome (RLS) during treatment; however, its incidence rate remains unclear. The aim of this study is investigate the rate of augmentation during RLS treatment. We searched 6 databases, including PubMed, OVID, Embase, Wiley citations, Web of Science research platform (including SciELO Citation Index, Medline, KCI Korean Journal Database, the Web of Science™ Core Collection), and the Cochrane library, and screened the reference lists of the included trials and recently published reviews. Randomized controlled trials and observational studies that reported augmentation events during RLS treatment. Primary RLS patients older than 18 years. No restrictions regarding intervention types were applied. Three investigators independently extracted and pooled the data to analyze the augmentation rate of the total sample and of patient subgroups with different interventions, treatment durations and drug regimens and different geographic origins. Fixed-effects or random-effects model was used for pooled analysis. A total of 60 studies involving 11,543 participants suggested an overall augmentation rate of 5.6% (95% confidence intervals (CI), 4.0–7.7). The augmentation incidence was 6.1% (95% CI, 4.1–9.1) for long-term treatment and 3.3% (95% CI, 1.4–7.3) for short-term treatment. In addition, 27.1% (95% CI, 12.3–49.5) of the levodopa-treated patients, 6.0% (95% CI, 4.1–8.8) of the patients treated with dopamine agonists, and 0.9% (95% CI, 0.2–3.3) of the patients taking pregabalin or gabapentin developed augmentation. Augmentation occurred in 7.2% (95% CI, 5.0–10.3) of the patients taking immediate-release drugs and in 1.7% (95% CI, 0.6–5.0) of the patients taking transdermal application. The main limitations are that the augmentation rates were not evaluated according to drug dosage, gender, and age and symptom severity. Approximately 5 to 6 in 100 RLS patients developed augmentation during treatment.