Objective: Here we investigated the consequences of the shift from rasagiline (RS) to SF in fluctuating PD patients. To this end, we selected patients from our cohort who developed side-effects to RS or showed worsening of symptoms and development or re-occurrence of fluctuations while on add-on therapy with RS.
Background: Monoamino-oxidase-B inhibitors (MAO-B-i) showed efficacy as add-on to levodopa in fluctuating PD patients. All MAO-B-i potentiate dopaminergic transmission. Safinamide (SF), however, showed also anti-glutamatergic activity, particularly at the dose of 100 mg/day. This latter feature may, indeed, be useful for further controlling motor and non-motor complications of PD.
Method: Twenty-seven patients were shifted from RS to SF (50 or 100 mg/day) in the last 18 months. Reasons for switching were side-effects to RS (n=2), development of fluctuations (n=8), re-occurrence of fluctuations while on therapy with RS (n=17). Fluctuations were investigated and measured by the WOQ-19, other assessments included the MDS-UPDRS-III scale and the NMS scale.
Results: Patients switched because of side-effects or development of fluctuations while on RS therapy displayed amelioration after SF. As to patients showing re-occurrence of fluctuations while on RS, 12/17 showed significant improvement after switching to SF. Overall analysis of the effects on fluctuations showed a significant benefit (p>0.01) on fluctuations by the switch from RS to SF.
Conclusion: Findings from the pilot study suggest that symptoms of WO non adequately controlled by add-on with RS may benefit from switch to SF.
To cite this abstract in AMA style:
M.S Sforza, F.E Pontieri, D.R Rinaldi, E.B Bianchini. A pilot study on the shift from rasagiline to safinamide in fluctuating Parkinson’s disease patients [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/a-pilot-study-on-the-shift-from-rasagiline-to-safinamide-in-fluctuating-parkinsons-disease-patients/. Accessed November 22, 2024.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-pilot-study-on-the-shift-from-rasagiline-to-safinamide-in-fluctuating-parkinsons-disease-patients/