Objective: Seeking new treatment strategies in atypical Parkinsonian syndromes

Background: Atypical parkinsonian syndromes (APS) include several entities leading to parkinsonism with atypical features such as early dementia, frequent falls, prominent dysautonomia or ataxia. Treatment with standard Parkinson disease therapies frequently lacks efficacy and although new treatments are being studied, no new breakthrough interventions have emerged so far. Sometimes amantadine has been useful for motor symptoms. Safinamide has multiple mechanisms of action and could represent a potential therapeutic drug.

Methods: We analyzed the effect of safinamide on motor fluctuations (MF) and freezing of gait (FOG) in patients with atypical parkinsonian syndromes (APS). All of them have been studied on baseline conditions (before safinamide) and after 1 month of treatment.

Results: We identified 5 patients with APS: 1 with dementia with Lewy bodies and 4 with probable multiple system atrophy (Mean aged 65 years. Mean evolution of disease: 7 years). All patients had FOG. Clinical response to safinamide 50 mg per day was positive in all these patients. FOG improved in all patients and also we identified improvement in other motor symptoms. There was no benefit in MF. None of them had secondary side effects or exacerbation of their symptoms. Unfortunately, in one patient the improvement was not maintained [table 1]

Conclusions: Although we present a small retrospective sample of cases, safinamide could be a potential new treatment for FOG in patients with APS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-safinamide-useful-for-atypical-parkinsonian-syndromes/