{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:10:10Z","timestamp":1782738610446,"version":"3.54.5"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Quality of life (QoL) is a critical outcome in the management of Parkinson\u2019s disease (PD), and is often affected more by non-motor symptoms (NMS) than motor features. While monoamine oxidase-B (MAO-B) and catechol-O-methyltransferase (COMT) inhibitors are commonly used with levodopa, their comparative impacts on QoL remains unclear. This study aimed to compare the effects of MAO-B and COMT inhibitors on global and domain-specific QoL in patients with PD using a Bayesian network meta-analysis (NMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A comprehensive literature search was conducted using PubMed\/Medline, Cochrane Library and Embase databases from the inception through April 30, 2025. Randomized controlled trials evaluating QoL using PDQ-39 or PDQ-8 in patients treated with MAO-B inhibitors (rasagiline, selegiline, safinamide) or COMT inhibitors (entacapone, opicapone, tolcapone) were included. A Bayesian NMA was performed using the \u201c\n                      <jats:italic>gemtc<\/jats:italic>\n                      \u201d package in R. Treatment effects were expressed as standardized mean differences (SMDs) with 95% credible intervals (CrIs). Treatment ranking was estimated using surface under the cumulative ranking curve (SUCRA) values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen RCTs comprised of 3,802 patients were included. The combination of extended-release rasagiline and pramipexole (P2B001) showed the most significant improvement in global QoL (SMD\u202f=\u202f\u22124.16; 95% CrI: \u22127.24 to \u22121.05), followed by rasagiline monotherapy (SMD\u202f=\u202f\u22122.38; 95% CrI: \u22124.32 to \u22120.42). Safinamide 100\u202fmg significantly improved emotional well-being (SMD\u202f=\u202f\u22122.56; 95% CrI: \u22125.13 to \u22120.04). SUCRA rankings confirmed the superior probability of benefits for rasagiline-based interventions across multiple QoL dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This network meta-analysis provides evidence that MAO-B inhibitors, particularly rasagiline and safinamide, may offer broader QoL benefits in patients with PD, especially in NMS such as emotional well-being. These findings support a more symptom-oriented and individualized treatment approach should be provided to patients with PD. Further well-designed head-to-head studies using standardized QoL measures and extended follow-up are needed to confirm these findings and guide clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      Registered in PROSPERO (CRD420251013028):\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251013028<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1753555","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T05:34:03Z","timestamp":1770183243000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of MAO-B and COMT inhibitors on quality of life in patients with Parkinson\u2019s disease: a Bayesian network meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Sung Ryul","family":"Shim","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics, Konyang University College of Medicine","place":["Daejeon, Republic of Korea"]},{"name":"Evidence Based Research Center, Konyang University Hospital","place":["Daejeon, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Jin","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyum-Yil","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Soonchunhyang University Seoul Hospital","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeho Greg","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Yale University School of Medicine","place":["New Haven, CT, United States"]},{"name":"Department of Public Health Sciences, University of Connecticut School of Medicine","place":["Farmington, CT, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon-Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Konyang University College of Medicine","place":["Daejeon, Republic of Korea"]},{"name":"Myunggok Medical Research Institute, Konyang University College of Medicine","place":["Daejeon, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","article-title":"Parkinson\u2019s 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