Pengaruh Pemberian Kafein terhadap Luaran Klinis Penyakit Parkinson Skor UPDRS
DOI:
https://doi.org/10.35790/ecl.v14i2.66057Keywords:
penyakit Parkinson; kafein; Unified Parkinson’s Disease Rating ScaleAbstract
Abstract: Parkinson’s disease is the second most common neurodegenerative disorder worldwide and still lacks of a disease-modifying therapy. Caffeine, an A2AR antagonist, may provide neuroprotection and modulate the dopaminergic system, potentially improving both motor and non-motor symptoms of this disease. This study aimed to evaluate the association of caffeine administration with Unified Parkinson’s Disease Rating Scale (UPDRS) score changes in patients with Parkinson’s disease through a meta-analysis of clinical trials. This meta-analysis showed that caffeine was associated with a statistically significant reduction in UPDRS III scores at enam weeks with moderate certainty, statistically insignificant reductions on UPDRS I, II, III (beyond six weeks), and IVFluctuations with moderate certainty, and statistically insignificant increases in UPDRS IVDyskinesia with low certainty. All UPDRS subscale changes might not be clinically meaningful. In conclusion, caffeine likely reduces UPDRS I, II, III, and IVFluctuation scores and may increase UPDRS IVDyskinesia, but may not be clinically meaningful. Nonetheless, caffeine remains a potential adjuvant candidate warranting further trials incorporating drug holidays to prevent tolerance
Keywords: Parkinson’s disease; caffeine; Unified Parkinson’s Disease Rating Scale
Abstrak: Penyakit Parkinson merupakan penyakit neurodegeneratif kedua tersering di dunia dan masih belum memiliki terapi yang dapat memodifikasi progresifitasnya. Kafein, antagonis A2AR, diduga memiliki efek neuroprotektif dan modulasi sistem dopaminergik yang berpotensi memperbaiki gejala motorik maupun non-motorik penyakit ini. Penelitian ini bertujuan untuk menilai hubungan pemberian kafein terhadap perubahan skor Unified Parkinson’s Disease Rating Scale (UPDRS) pada pasien penyakit Parkinson melalui meta-analisis uji klinis. Hasil meta-analisis menunjukkan bahwa pemberian kafein secara statistik bermakna menurunkan skor UPDRS III durasi intervensi enam minggu dengan keyakinan sedang, tidak secara statistik bermakna menurunkan skor UPDRS I, II, III (selain durasi intervensi enam minggu), dan IVFluktuasi dengan keyakinan sedang, serta tidak secara statistik bermakna meningkatkan skor UPDRS IVDiskinesia dengan keyakinan rendah. Semua perubahan luaran subskala UPDRS mungkin tidak bermakna secara klinis. Simpulan penelitian ini ialah pemberian kafein kemungkinan besar menurunkan skor UPDRS I, II, III, dan IV bagian fluktuasi, serta mungkin meningkatkan skor UPDRS IVDiskinesia, tetapi mungkin tidak bermakna secara klinis. Meskipun demikian, terdapat potensi kafein sebagai adjuvan yang masih memerlukan penelitian lanjutan dengan drug holiday untuk mencegah toleransi.
Kata kunci: penyakit Parkinson; kafein; Unified Parkinson’s Disease Rating Scale
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