The efficacy and safety of riluzole for neurodegenerative movement disorders: a systematic review with meta-analysis

Figures & data

Figure 1. Study flow diagram.

Table 1. Baseline characteristics of included studies.

Study	Study design	No. of randomized	Subjects	Intervention	Risk of biasa
Bara-Jimenez et al. (2006)	Parallel, 3-stage	15	Subjects with PD	Randomly assigned into riluzole or placebo alone, in a 4:1 ratio. After a 1-week placebo run-in, riluzole were given 1 week at 50 mg bid and then 1 week at 100 mg bid) . The remaining patients received placebo throughout the 3 weeks of study	L,L,L,L,L,L
Bensimon et al. (2009)	Parallel, multicenter	767	Clinically probable PSP and MSA	Stratified for diseases (MSA or PSP) randomly assigned into riluzole (50-200 mg/day) or placebo as ratio 1:1 for 3 years	L,L,L,L,L,L
Braz et al. (2004)	Parallel	16	PD with dyskinesia induced by levodopa	Randomly assigned into riluzole (50 mg bid) or placebo as ratio 1:1 for 7 consecutive days	U,U,U,L,L,L
Jankovic and Hunter (2002)	Parallel	20	Early stage PD	Randomly assigned into riluzole (50 mg bid) or placebo as ratio 1:1 for 6 months	U,U,U,U,L,L
Seppi et al. (2006)	Crossover	10	Clinically probable MSA	Riluzole (100 mg bid) and placebo for 4 weeks each with a 4-week washout period	U,U,U,U,L,L
Huntington Study Group (2003)	Parallel, multicenter	63	Confirmed HD	Randomly assigned into receiving placebo, riluzole 100 mg/day, or riluzole 200 mg/day for 8 weeks	L,L,L,L,L,L
Landwehrmeyer et al. (2007)	Parallel, multicenter	537	Confirmed HD	Randomly assigned in a 2:1 ratio to riluzole (50mg twice daily) or placebo for 3 years	L,U,L,L,L,L
Ristori et al. (2010)	Parallel, multicenter	40	Cerebellar ataxia	Randomly assigned to riluzole (100 mg/day) or placebo for 8 weeks	L,U,L,L,L,L
Romano et al. (2015)	Parallel, multicenter	60	Spinocerebellar ataxia or Friedreich’s ataxia	Random assignment to riluzole (50 mg orally, twice daily) or placebo for 12 months	L,L,L,L,L,L

^aRisk of bias (random sequence generation, allocation concealment, patient blind, assessor blind, drop-out or withdraw, selective report), L: low risk; U: unclear risk; H: high risk; HD: Huntington disease; MSA: multiple system atrophy; PD: Parkinson’s disease; PSP: progressive supranuclear palsy.

Figure 2. Changes of motor score after the treatment of riluzole versus placebo. Bara-Jimenez et al. (2006): Unified Parkinson's disease Rating Scale (UPDRS) motor. Baseline scores were not provided, however, none of the differences between riluzole and placebo baseline scores were significant. Therefore, we compared the scores at the endpoint. Bensimon et al. (2009): Short Motor Disability Scale. Braz et al. (2004): UPDRS motor. We combined the scores of ON and OFF state as two groups for each intervention. Huntington Study Group (2003): Unified Huntington’s Disease Rating Scale (UHDRS) motor. Jankovic and Hunter (2002): Movement Time (MT) Index score. It was calculated as the averaged performance seconds/count) across the Single Button Index MT, Single Button Wrist MT, and Alternate Button MT tests over three right- and three left-handed trials. Landwehrmeyer et al. (2007): UHDRS motor. Ristori et al. (2010): International Cooperative Ataxia Rating Scale. Romano et al. (2015): the Scale for the Assessment and Rating of Ataxia. Seppi et al. (2006): UPDRS motor. For all the scales, the more scores meant the more severe movement disorders.

Figure 3. Number of participants with adverse events. Bensimon et al. (2009): The data of serious adverse events but not adverse events were available.

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Bensimon G, Ludolph A, Agid Y, et al. (2009). Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study. Brain 132:156–71.

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Jankovic J, Hunter C. (2002). A double-blind, placebo-controlled and longitudinal study of riluzole in early Parkinson's disease. Parkinsonism Relat Disord 8:271–6.

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Seppi K, Peralta C, Diem-Zangerl A, et al. (2006). Placebo-controlled trial of riluzole in multiple system atrophy. Eur J Neurol 13:1146–8.

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Landwehrmeyer GB, Dubois B, de Yébenes JG, et al. (2007). Riluzole in Huntington's disease: a 3-year, randomized controlled study. Ann Neurol 62:262–72.

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Ristori G, Romano S, Visconti A, et al. (2010). Riluzole in cerebellar ataxia: a randomized, double-blind, placebo-controlled pilot trial. Neurology 74:839–45.

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Romano S, Coarelli G, Marcotulli C, et al. (2015). Riluzole in patients with hereditary cerebellar ataxia: a randomised, double-blind, placebo-controlled trial. Lancet Neurol 14:985–91.

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