Rasagiline and safinamide as a dopamine-sparing therapy for Parkinson’s disease
Abstract
Objectives
To evaluate whether the prescription of monoamine oxidase B inhibitors (MAOB-I), rasagiline and safinamide, contributes to the reduction of levodopa and/or dopamine agonists (DA) dose in order to minimize adverse effects.
Materials and Methods
A total of 724 patients with Parkinson's disease (PD) have been prospectively included in our database since the year 2000, representing a total of 5124 visits. For each patient and visit, antiparkinsonian treatment was recorded. In the presence of rasagiline and safinamide, we analysed the evolution of levodopa equivalent dose (LED) and LED for DA (LED-DA).
Results
The data obtained from the 1664 visits between 2006 and 2010 (321 patients) and the 1709 visits between 2014 and 2018 (403 patients) were analysed in order to assess the impact of the introduction of rasagiline and safinamide, respectively. The annual mean LED remained stable without statistically significant differences. In the first period (impact of rasagiline), the annual mean LED-DA in 2010 was significantly higher than in 2006 (P = 0.001). In the second period (impact of safinamide), the annual mean LED-DA in 2018 was significantly lower than in 2014 (P = 0.002). A repeated-measure analyses of LED-DA including only patients who had taken safinamide showed a statistically significant decrease in LED-DA (P = 0.027).
Conclusions
The introduction of MAOB-I in the overall treatment of PD as part of routine clinical practice has not helped to reduce annual mean LED. However, safinamide reduces annual mean LED-DA and may be linked to a reduction in dose-dependent adverse effects in the long term.
DISCLOSURE
A. Avila has received honoraria from Zambon, UCB Pharma, Qualigen, Bial and Teva and sponsorship from Zambon and Teva for attending conferences. N. Caballol has received honoraria from Bial, Italfármaco, Qualigen, Zambon, UCB, Teva and KRKA and sponsorship from Zambon, TEVA and AbbVie for attending medical conferences. M. Martín-Baranera, I. Gómez-Ruiz, M. Balagué-Marmaña, A. Planas-Ballvé and X. Cardona report no disclosures.
CONFLICT OF INTEREST
None of the authors have any financial disclosures or conflicts of interest relevant to this work.
