Objective: We aimed to investigate the efficacy and safety of rasagiline in addition to levodopa in patients with dementia with Lewy bodies (DLB).

Background: Management of motor symptoms in DLB remains a challenge due to frequent adverse effects. Some patients have modest effect of levodopa while others do not respond to treatment. Therefore, it is necessary to modify an approach to antiparkinsonian drug administration in patients with DLB. We hypothesize that irreversible selective second-generation MAO-B inhibitor rasagiline can be effective and safe in DLB patients with gait disturbances. Its efficacy could be related to non-specific PEA-associated increase of monoamines: dopamine, noradrenalin, serotonin.

Methods: An open observational study included 12 patients with probable DLB received rasagiline 1 mg once daily during 12 weeks. The clinical assessment included Timed “Up&Go” test (TUG, 3 meters), Freezing of Gait Questionnaire (FOGQ), the motor section of the Unified Parkinson’s disease rating scale (UPDRS), Gait Abnormality Rating Scale, Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, Epworth Sleepiness Scale, Neuropsychiatric Inventory (NPI-4), SCOPA-AUT Scale.

Results: All patients completed treatment. After 12 weeks of treatment with rasagiline the patients have shown some improvement of gait disturbances. UPDRS level improved on 3,2 (8%, p=0,1). TUG test tended to be improved but not significantly. FOGQ decreased on 2 points (p=0,08). Rasagiline did not worsen cognitive function. One patient had clinical significant episode of orthostatic hypotension. Hallucinations were appeared in one patient.

Conclusions: Rasagiline has shown safety and some clinical benefit for gait disturbances in patients with DLB. Placebo-controlled randomized trials are warranted to verify this data.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-and-safety-of-rasagiline-in-treatment-of-gait-disturbances-in-dementia-with-lewy-bodies/