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. 2023 May 25;18(5):e0286066.
doi: 10.1371/journal.pone.0286066. eCollection 2023.

The effects of safinamide on dysphagia in Parkinson's disease

Makito Hirano  1 , Makoto Samukawa  1 , Chiharu Isono  2 , Yoshitaka Nagai  1
Affiliations

The effects of safinamide on dysphagia in Parkinson's disease

Makito Hirano et al. PLoS One. .

Abstract

Dysphagia is a potentially fatal symptom of Parkinson's disease (PD) and is characterized by frequent silent aspiration, a risk factor for aspiration pneumonia. The transdermal dopamine agonist rotigotine alleviates dysphagia in patients with PD and is more effective than oral levodopa, suggesting the importance of continuous dopaminergic stimulation (CDS) in swallowing. Safinamide is a monoamine oxidase B (MAOB) inhibitor that facilitates CDS. In this retrospective open-label evaluator-blinded research, swallowing functions in nine patients with PD were examined using a video fluoroscopic swallowing study (VFSS) before and after treatment with 50 mg of oral safinamide. The VFSS results showed that safinamide significantly improved some swallowing measures during oral and pharyngeal phases, including oral transit time and pharyngeal transit time, without worsening of any measures. Notably, improvements in lip closure, an oral phase component, seemed to be most attributable to improvements in oral phase scores. In conclusion, a medicine for CDS may effectively improve swallowing functions in patients with PD. This is the first study to show that the MAOB inhibitor safinamide partly but significantly improves swallowing function in patients with PD.

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Conflict of interest statement

Potential conflicts of interest included: M. Hirano has received funding for speaker honoraria from Sumitomo, Ono, Otsuka, Novartis, Kyowa-Kirin, Eisai, and Takeda; and has received Grants-in-Aid from Japan’s Ministry of Education, Culture, Sports, Science and Technology; AMED in Japan; and research support from Kindai University. M. Samukawa has received funding for speaker honoraria from Takeda, FP, Eisai, and Sumitomo Pharmaceutical. C. Isono reports no disclosures. Y. Nagai has received funding for speaker honoraria from Sumitomo, Kyowa-Kirin, Tanabe-Mitsubishi, Amgen, and Takeda; and has received Grants-in-Aid from Japan’s Ministry of Education, Culture, Sports, Science and Technology; AMED in Japan. He also has received scholarship donation from Otsuka, Kyowa-Kirin, Tanabe-Mitsubishi, Fujimoto, Takeda, Sumitomo, Daiichi-Sankyo, Esai, and Chugai. These do not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Swallowing function in nine patients with PD before (pre) and 32 ± 5 days after (post) treatment with safinamide.
(A) Videofluoroscopic swallowing study (VFSS) showed significant improvements in total score and oral phase score. (p values were calculated using the Wilcoxon signed-rank test; *, significant improvement after adjusting for multiple comparisons using the Benjamini–Hochberg method) Pharyngeal phase score and Dysphagia Outcome and Severity Scale (DOSS) score did not reach statistical significance (NS). (B) VFSS results showed improvement in oral transit time (OTT) and pharyngeal transit time (PTT) after treatment (p values were calculated using the Wilcoxon signed-rank test; *, significant improvement after adjusting for multiple comparisons using the Benjamini–Hochberg method). Shaded regions indicate normal ranges for OTT and PTT.
See this image and copyright information in PMC

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