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Review
. 2023 Jun;130(6):847-861.
doi: 10.1007/s00702-023-02623-8. Epub 2023 Mar 24.

Clinical benefit of MAO-B and COMT inhibition in Parkinson's disease: practical considerations

Martin Regensburger  1 , Chi Wang Ip  2 , Zacharias Kohl  3 , Christoph Schrader  4 , Peter P Urban  5 , Jan Kassubek  6 , Wolfgang H Jost  7
Affiliations
Review

Clinical benefit of MAO-B and COMT inhibition in Parkinson's disease: practical considerations

Martin Regensburger et al. J Neural Transm (Vienna). 2023 Jun.

Abstract

Inhibitors of monoamine oxidase B (MAO-B) and catechol-O-methyltransferase (COMT) are major strategies to reduce levodopa degradation and thus to increase and prolong its effect in striatal dopaminergic neurotransmission in Parkinson's disease patients. While selegiline/rasagiline and tolcapone/entacapone have been available on the market for more than one decade, safinamide and opicapone have been approved in 2015 and 2016, respectively. Meanwhile, comprehensive data from several post-authorization studies have described the use and specific characteristics of the individual substances in clinical practice under real-life conditions. Here, we summarize current knowledge on both medication classes, with a focus on the added clinical value in Parkinson's disease. Furthermore, we outline practical considerations in the treatment of motor fluctuations and provide an outlook on ongoing studies with MAO-B and COMT inhibitors.

Keywords: COMT inhibitors; MAO-B inhibitors; Motor fluctuations; Parkinson’s disease.

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Conflict of interest statement

M. Regensburger was a speaker for Orphalan and received travel compensation from Desitin. Chi Wang Ip is a consultant and/or speaker for the companies Ipsen and Merz. Zacharias Kohl was consultant and/or speaker for AbbVie, Bial, Desitin, UCB, Novartis. Christoph Schrader was speaker and consultant for Abbvie and received travel grants from Abbbie, Merz Deutschland, and Desitin. Peter Urban reports no competing interests. Jan Kassubek has received honoraria or consultation fees from AbbVie, Bial, Biogen, Desitin, Esteve, Licher MT, Medtronic, NeuroDerm, Novartis, STADA, UCB Pharma, and Zambon; in addition, he is Specialty Chief Editor for Frontiers in Neurology and Associate Editor (Neurology) for Therapeutic Advances in Chronic Disease. W. Jost is or was a consultant and/or speaker for the following companies: Abbvie, Bial, Desitin, Kyowa Kirin, Stada, UCB, Zambon.

References

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