***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In a multinational , double-blind , placebo-controlled trial ( NCT00474058 ) , 287 subjects with Parkinson 's disease ( PD ) and unsatisfactory early-morning motor symptom control were r and omized 2:1 to receive rotigotine ( 2–16 mg/24 hr [ n = 190 ] ) or placebo ( n = 97 ) . Treatment was titrated to optimal dose over 1–8 weeks with subsequent dose maintenance for 4 weeks . Early-morning motor function and nocturnal sleep disturbance were assessed as co primary efficacy endpoints using the Unified Parkinson 's Disease Rating Scale ( UPDRS ) Part III ( Motor Examination ) measured in the early morning prior to any medication intake and the modified Parkinson 's Disease Sleep Scale ( PDSS-2 ) ( mean change from baseline to end of maintenance [ EOM ] , last observation carried forward ) . At EOM , mean UPDRS Part III score had decreased by −7.0 points with rotigotine ( from a baseline of 29.6 [ st and ard deviation ( SD ) 12.3 ] and by −3.9 points with placebo ( baseline 32.0 [ 13.3 ] ) . Mean PDSS-2 total score had decreased by −5.9 points with rotigotine ( from a baseline of 19.3 [ SD 9.3 ] ) and by −1.9 points with placebo ( baseline 20.5 [ 10.4 ] ) . This represented a significantly greater improvement with rotigotine compared with placebo on both the UPDRS Part III ( treatment difference : −3.55 [ 95 % confidence interval ( CI ) −5.37 , −1.73 ] ; P = 0.0002 ) and PDSS-2 ( treatment difference : −4.26 [ 95 % CI −6.08 , −2.45 ] ; P < 0.0001 ) . The most frequently reported adverse events were nausea  ( placebo , 9 % ; rotigotine , 21 % ) , application site reactions  ( placebo , 4 % ; rotigotine , 15 % ) , and dizziness ( placebo , 6 % ; rotigotine 10 % ) . Twenty-four-hour transdermal delivery of rotigotine to PD patients with early-morning motor dysfunction result ed in significant benefits in control of both motor function and nocturnal sleep disturbances . © 2010 Movement Disorder ABSTRACT – The effects of bromocriptine in patients with Parkinson 's disease manifesting various problems in levodopa therapy were tested in a double‐blind manner with the collaboration of 59 institutions . The slow and low principle was in part adopted . Either bromocriptine or placebo was added to levodopa Abstract Objective : Rasagiline is a second-generation , irreversible MAO-B inhibitor ( MAOB-I ) previously shown to be efficacious and well-tolerated compared to placebo in the treatment of early Parkinson ’s disease ( PD ) . ACTOR ( ACceptabilité TOlérance Rasagiline ) was a 15-week , multi-center , r and omized , double-blind study aim ed to assess the safety and tolerability of rasagiline compared to the dopaminergic agonist pramipexole in the treatment of early PD . Methods : Patients with early , untreated idiopathic PD were r and omized to receive 1 mg rasagiline ( n = 53 ) or 1.5 mg pramipexole ( n = 56 ) daily . The primary outcome was the number of patients experiencing a ‘ clinical ly important adverse event ’ ( classified as a serious adverse event , an event leading to withdrawal or severe according to the patient ) . Safety outcomes were evaluated by the investigator and the patient . Analysis of the primary criterion was a comparative analysis using the chi-squared test . The Wilcoxon Mann – Whitney test was conducted to test the severity of patient-reported adverse events . Other tests performed include a covariance analysis and Student ’s t-tests . Results : Mean disease duration was 3.4 months , and mean age was 62.6 years . Of patients taking  pramipexole  , 44.6 % reported at least one ‘ clinical ly important ’ adverse event compared to 32.1 % of patients taking rasagiline ; non-inferiority of rasagiline was reached , with a difference in proportions of −12.6 % [ confidence interval of −27.8 % ; 2.6 % ] . There were no significant differences in clinical effectiveness between the treatments , measured by clinical and patient global impression of improvement ( CGI-I , PGI-I ) and PDQ-8 scales . A significant decrease in the incidence of gastrointestinal symptoms ( p = 0.015 ) and sleep disorders ( p = 0.027 ) was reported by physicians in the rasagiline group compared to the pramipexole group ; the propensity to sleepiness improved significantly in the rasagiline group ( p = 0.020 ) , and worsened in the pramipexole group ( p = 0.042 ) . Limitations : Limitations of this study include the limited sample size due to the lower than anticipated recruitment and the accidental inclusion of a patient who had taken contraindicated medication . Conclusions : In this study , the safety profile of rasagiline had clinical ly favorable differences in gastrointestinal and sleep adverse events compared to pramipexole , whilst showing comparable clinician and patient-rated clinical effectiveness as a monotherapy for the treatment of early idiopathic PD BACKGROUND There is debate about whether the initial treatment for patients with Parkinson 's disease should be levodopa or a dopamine agonist . METHODS In this prospect i ve , r and omized , double-blind study , we compared the safety and efficacy of the dopamine D2-receptor agonist ropinirole with that of levodopa over a period of five years in 268 patients with early Parkinson 's disease . If symptoms were not adequately controlled by the assigned study medication , patients could receive supplementary levodopa , administered in an open-label fashion . The primary outcome measure was the occurrence of dyskinesia . RESULTS Eighty-five of the 179 patients in the ropinirole group ( 47 percent ) and 45 of the 89 patients in the levodopa group ( 51 percent ) completed all five years of the study . In the ropinirole group 29 of the 85 patients ( 34 percent ) received no levodopa supplementation . The analysis of the time to dyskinesia showed a significant difference in favor of ropinirole ( hazard ratio for remaining free of dyskinesia , 2.82 ; 95 percent confidence interval , 1.78 to 4.44 ; P<0.001 ) . At five years , the cumulative incidence of dyskinesia ( excluding the three patients who had dyskinesia at base line ) , regardless of levodopa supplementation , was 20 percent ( 36 of 177 patients ) in the ropinirole group and 45 percent ( 40 of 88 patients ) in the levodopa group . There was no significant difference between the two groups in the mean change in scores for activities of daily living among those who completed the study . Adverse events led to the early withdrawal from the study of 48 of 179 patients in the ropinirole group ( 27 percent ) and 29 of 89 patients in the levodopa group ( 33 percent ) . The mean ( + /-SD ) daily doses given by the end of the study were 16.5+/-6.6 mg of ropinirole ( plus 427+/-221 mg of levodopa in patients who received supplementation ) and 753+/-398 mg of levodopa ( including supplements ) . CONCLUSIONS Early Parkinson 's disease can be managed successfully for up to five years with a reduced risk of dyskinesia by initiating treatment with ropinirole alone and supplementing it with levodopa if necessary OBJECTIVE This study compares once-daily ropinirole 24-h prolonged release and three-times-daily ropinirole immediate release in patients with early Parkinson 's disease . METHODS This multicentre , double-blind , non-inferiority crossover study involved 161 patients r and omized to one of four formulation sequences : ( 1 ) immediate release-immediate release-prolonged release ; ( 2 ) immediate release-prolonged release-prolonged release ; ( 3 )  prolonged release-prolonged release-immediate release ; ( 4 ) prolonged release-immediate release-immediate release . During a 12-week dose-titration period , ropinirole immediate release was titrated according to the approved labelling ; titration of ropinirole 24-h prolonged release started at a higher dose and was more rapid . Patients then entered three consecutive , flexible-dose , 8-week maintenance periods . At the end of the first maintenance period , half of the patients in each formulation group switched to the same or closest dose of the alternative formulation ; remaining patients switched at the end of the second maintenance period . RESULTS At the end of titration , before the first dose switch , there were substantial reductions in mean Unified Parkinson 's Disease Rating Scale ( UPDRS ) motor scores . During maintenance periods , both groups showed similar efficacy on the UPDRS motor score . Overall mean ( st and ard error ) change from period baseline was -0.1 ( 0.28 ) for ropinirole 24-h prolonged release , and 0.6 ( 0.30 ) for ropinirole immediate release ( adjusted mean treatment difference -0.7 ; 95 % confidence interval [ CI ] : -1.51 , 0.10 ; p = 0.0842 ) . The upper limit of the 95 % CI was less than the predefined threshold of 3 points for non-inferiority . Ropinirole 24-h prolonged release was well-tolerated when titrated more rapidly than ropinirole immediate release ; overnight switching between formulations was also well-tolerated . Study limitations included complexity of the non-inferiority study design and the forced dose-titration schedule . CONCLUSION Ropinirole 24-h prolonged release was effective and well-tolerated in patients with early Parkinson 's disease We compared the antitremor effect of pramipexole , pergolide , or placebo in Parkinson 's disease ( PD ) . A double-blind , r and omly controlled , parallel protocol was deployed to examine the effects of placebo , pergolide , and pramipexole [ doses escalated to 1.5 mg three times daily ( t.i.d . ) over 3 months ] on a compound Tremor Index ( TI ) and Unified Parkinson 's Disease Rating Scale ( UPDRS ) part III .  Thirty PD patients ( 19 men , 11 women ; mean age 69 years , range 54 - 80 years ; mean disease duration 3.9 years , range , 0.5 - 10 years ) participated in the study , with 10 patients in each arm . Six subjects failed to complete the study ( 4 on pergolide and 2 on placebo ) . Analysis of covariance demonstrated strong evidence for a treatment effect on both TI and UPDRS III . There was no significant difference between the active treatments on either TI or UPDRS III . Both pergolide and pramipexole were significantly better than placebo . The results indicate that pergolide and pramipexole ( 1.5 mg t.i.d . ) have similar anti-PD tremor and UPDRS III actions that are significantly superior to placebo . Patients on pergolide were more likely to drop out because of adverse events than those on pramipexole We compared the efficacy , safety , an tolerability of pramipexole , an aminobenzathiazol-derived dopamine agonist with novel properties , with those of placebo in advanced PD patients with motor fluctuations under levodopa treatment .  Pramipexole improved motor function of patients during " on " and " off " periods , decreased the time spent in " off " periods , reduced the severity of " off " periods , decreased disability and PD severity during " on " and " off " periods , as assessed by the Unified Parkinson Disease Rating Scale , and permitted a reduction in levodopa dosage . Adverse effects related to the central nervous system were similar to those reported with other dopamine agonists , and the gastrointestinal and cardiovascular tolerability of the compound was satisfactory OBJECTIVE The common cold ( acute viral respiratory tract infection ) is one of the most frequent diseases in man , world-wide . Clinical ly relevant efficacy should include early improvement of all symptoms . Results of a clinical trial of a commercially available fixed combination herbal remedy ( Radix echinaceae , Radix baptisiae , Herba thujae ) are reported here . The aim of this study was to verify clinical efficacy shown in recent studies under ( i ) good clinical practice ( GCP ) quality assurance and ( ii ) common situations at family doctors . METHODS Patients attending one of 15 study centres ( practitioners ) as a result of an acute common cold were r and omised to the double-blind placebo-controlled  study . Three tablets of study medication were applied t.i.d . for 7 to 9 days . Patients daily documented the intensity of 18 cold symptoms , as well as the cold overall , using a 10-point scale and estimated their general well-being using the Welzel-Kohnen colour scales . Additionally , the severity of illness was assessed by the physician on days 4 and 8 ( CGI-1 ) . The main and confirmatory outcome measure was expressed as a total efficacy value . This was gauged from the z-st and ardised AUC values of the primary endpoints ( 
    Output:
    
Results of NMA indicate that patients with levodopa , pramipexole , ropinirole and selegiline exhibited a significantly improved UPDRS III than those with lazabemide .
To sum up , levodopa , selegiline , ropinirole and rotigotine were recommended for PD patients as they appeared relatively high efficacy and tolerability