In a nutshell
This study reviewed the effectiveness and safety of safinamide (Xadago) treatment in patients with Parkinson’s disease (PD). Researchers suggested that safinamide improves the outcomes of patients also taking levodopa.
Some background
PD is a chronic disease that affects more than 10 million people worldwide. It affects brain cells which lose their abilities to control body functions causing symptoms such as tremors. The standard PD treatment is levodopa alone or in combination. However, long-term levodopa treatment is associated with dyskinesia (involuntary movements such as jerks or twitches) and wearing-OFF. Wearing-OFF consists of the PD symptoms coming back (sometimes worse) before the next dose of levodopa. This side effect decreases the quality of life of patients.
When wearing-OFF symptoms appear MAOB inhibitors such as safinamide can be a useful treatment. Safinamide remains in the bloodstream for longer than levodopa, therefore improving wearing-OFF symptoms. Prior studies showed that safinamide improves the physical symptoms and quality of life of PD patients. However, the effectiveness of safinamide in PD patients with and without wearing-OFF symptoms was never compared.
Methods & findings
This study reviewed other 6 studies including 2792 patients with PD. The main outcomes measured were ON-time without symptoms.
In patients with wearing-OFF symptoms, the addition of safinamide (100 mg) to levodopa therapy increased ON-time without troublesome dyskinesia by 0.95 hours. It also reduced OFF-time by 1.06 hours and improved PD symptoms. Similar results were observed for the dose of 50 mg safinamide.
In patients with OFF-symptoms safinamide at 100 or 50 mg made no significant difference in ON-time. However, in the same patients, the doses of 100 and 50 mg improved PD symptoms. In patients without OFF symptoms 100 mg of safinamide improved the PD symptoms. On the contrary, the doses of 50 and 200 mg showed little to no improvement in PD symptoms.
The bottom line
This study concluded that safinamide at 50 and 100 mg in improved PD symptoms in patients with OFF symptoms.
The fine print
This study was based on different studies with different protocols. Therefore firm conclusions were difficult.
Published By :
Clinical drug investigation
Date :
Mar 05, 2021
