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. 2017 Jun;264(6):1254-1263.
doi: 10.1007/s00415-017-8523-y. Epub 2017 May 26.

Efficacy of rasagiline and selegiline in Parkinson's disease: a head-to-head 3-year retrospective case-control study

Emanuele Cereda  1 , Roberto Cilia  2 , Margherita Canesi  2 , Silvana Tesei  2 , Claudio Bruno Mariani  2 , Anna Lena Zecchinelli  2 , Gianni Pezzoli  2
Affiliations

Efficacy of rasagiline and selegiline in Parkinson's disease: a head-to-head 3-year retrospective case-control study

Emanuele Cereda et al. J Neurol. 2017 Jun.

Erratum in

Abstract

Monoamine oxidase type B (MAO-B) inhibitors, such as selegiline and rasagiline, can be used as monotherapy or adjuvant therapy to levodopa in Parkinson's disease (PD). Data on long-term efficacy of MAO-B inhibitors are limited with no head-to-head comparison available to date. The aim of this case-control retrospective study was to analyze data from patients with PD attending the Parkinson Institute (Milan, Italy) over a 6-year period (2009-2015) and compare the effects of selegiline and rasagiline on levodopa treatment outcomes. Patients with PD treated with either selegiline (n = 85) or rasagiline (n = 85) for 3 years as well as a control group of patients (N = 170) who have never received MAO-B inhibitors, were matched for gender, disease duration (±1 year) and age (±1 year) at baseline assessment (ratio 1:1:2). The Unified PD Rating Scale and the Hoehn-Yahr staging system were used for clinical comparisons. At baseline, mean PD duration was 6.5 years and clinical features were comparable across all three groups. After a mean follow-up of approximately 37 months, no differences in clinical progression of motor and non-motor symptoms were observed between the three groups. However, MAO-B inhibitor use was associated with ~2-fold lower change in daily dose of levodopa (p < 0.001) and lower dyskinesia scores (p = 0.028) than non-users. No intra-class differences were observed between selegiline and rasagiline. Long-term use of MAO-B inhibitors resulted in a significant reduction in levodopa requirements and a lower frequency of dyskinesias in patients with PD. Selegiline and rasagiline had equal efficacy in controlling motor symptoms in PD patients on optimized therapy.

Keywords: Levodopa; Monoamine oxidase inhibitors; Parkinson’s disease; Rasagiline; Selegiline.

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Conflict of interest statement

Funding

This work was supported by the Fondazione Grigioni per il Morbo di Parkinson.

Ethical standards

This study was performed in agreement with the principles of the Declaration of Helsinki and the local Ethics Committee was notified in compliance with Italian legislation on retrospective studies. For every patient included, the written informed consent previously signed to allow the use of clinical data for research purposes was retrieved.

Conflicts of interest

The authors certify that over the last 3 years there were no affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed herein. Dr. Cilia received honoraria for symposia from Boehringer-Ingelheim, Lundbeck, UCB pharma. Emanuele Cereda has received consultancy honoraria and investigator grants from the Fondazione Grigioni per il Morbo di Parkinson, the Fondazione IRCCS Policlinico San Matteo and Nutricia Italia.

Figures

Fig. 1
Fig. 1
Flowchart of the study population
Fig. 2
Fig. 2
Prevalence of dyskinesias [a disabling dyskinesias (UPDRS Part IV-items 33 score ≥2) are highlighted in black color] and motor fluctuations (b) in the study population. Controls (Co.) indicate patients who did not receive any monoamine oxidase type B (MAO-B) inhibitor (Ras rasagiline, Sel selegiline)
See this image and copyright information in PMC

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