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Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations
Levodopa is effective for the motor symptoms of Parkinson's disease (PD), but is associated with motor fluctuations and dyskinesia. Many patients require add-on therapy to improve motor fluctuations without exacerbating dyskinesia. The objective of this Phase III, multicenter, double-blind, pla...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BlackWell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285943/ https://www.ncbi.nlm.nih.gov/pubmed/24323641 http://dx.doi.org/10.1002/mds.25751 |
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author | Borgohain, Rupam Szasz, J Stanzione, P Meshram, C Bhatt, M Chirilineau, D Stocchi, F Lucini, V Giuliani, R Forrest, E Rice, P Anand, R |
author_facet | Borgohain, Rupam Szasz, J Stanzione, P Meshram, C Bhatt, M Chirilineau, D Stocchi, F Lucini, V Giuliani, R Forrest, E Rice, P Anand, R |
author_sort | Borgohain, Rupam |
collection | PubMed |
description | Levodopa is effective for the motor symptoms of Parkinson's disease (PD), but is associated with motor fluctuations and dyskinesia. Many patients require add-on therapy to improve motor fluctuations without exacerbating dyskinesia. The objective of this Phase III, multicenter, double-blind, placebo-controlled, parallel-group study was to evaluate the efficacy and safety of safinamide, an α-aminoamide with dopaminergic and nondopaminergic mechanisms, as add-on to l-dopa in the treatment of patients with PD and motor fluctuations. Patients were randomized to oral safinamide 100 mg/day (n = 224), 50 mg/day (n = 223), or placebo (n = 222) for 24 weeks. The primary endpoint was total on time with no or nontroublesome dyskinesia (assessed using the Hauser patient diaries). Secondary endpoints included off time, Unified Parkinson's Disease Rating Scale (UPDRS) Part III (motor) scores, and Clinical Global Impression-Change (CGI-C). At week 24, mean ± SD increases in total on time with no or nontroublesome dyskinesia were 1.36 ± 2.625 hours for safinamide 100 mg/day, 1.37 ± 2.745 hours for safinamide 50 mg/day, and 0.97 ± 2.375 hours for placebo. Least squares means differences in both safinamide groups were significantly higher versus placebo. Improvements in off time, UPDRS Part III, and CGI-C were significantly greater in both safinamide groups versus placebo. There were no significant between-group differences for incidences of treatment-emergent adverse events (TEAEs) or TEAEs leading to discontinuation. The addition of safinamide 50 mg/day or 100 mg/day to l-dopa in patients with PD and motor fluctuations significantly increased total on time with no or nontroublesome dyskinesia, decreased off time, and improved parkinsonism, indicating that safinamide improves motor symptoms and parkinsonism without worsening dyskinesia. |
format | Online Article Text |
id | pubmed-4285943 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BlackWell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-42859432015-01-14 Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations Borgohain, Rupam Szasz, J Stanzione, P Meshram, C Bhatt, M Chirilineau, D Stocchi, F Lucini, V Giuliani, R Forrest, E Rice, P Anand, R Mov Disord Research Articles Levodopa is effective for the motor symptoms of Parkinson's disease (PD), but is associated with motor fluctuations and dyskinesia. Many patients require add-on therapy to improve motor fluctuations without exacerbating dyskinesia. The objective of this Phase III, multicenter, double-blind, placebo-controlled, parallel-group study was to evaluate the efficacy and safety of safinamide, an α-aminoamide with dopaminergic and nondopaminergic mechanisms, as add-on to l-dopa in the treatment of patients with PD and motor fluctuations. Patients were randomized to oral safinamide 100 mg/day (n = 224), 50 mg/day (n = 223), or placebo (n = 222) for 24 weeks. The primary endpoint was total on time with no or nontroublesome dyskinesia (assessed using the Hauser patient diaries). Secondary endpoints included off time, Unified Parkinson's Disease Rating Scale (UPDRS) Part III (motor) scores, and Clinical Global Impression-Change (CGI-C). At week 24, mean ± SD increases in total on time with no or nontroublesome dyskinesia were 1.36 ± 2.625 hours for safinamide 100 mg/day, 1.37 ± 2.745 hours for safinamide 50 mg/day, and 0.97 ± 2.375 hours for placebo. Least squares means differences in both safinamide groups were significantly higher versus placebo. Improvements in off time, UPDRS Part III, and CGI-C were significantly greater in both safinamide groups versus placebo. There were no significant between-group differences for incidences of treatment-emergent adverse events (TEAEs) or TEAEs leading to discontinuation. The addition of safinamide 50 mg/day or 100 mg/day to l-dopa in patients with PD and motor fluctuations significantly increased total on time with no or nontroublesome dyskinesia, decreased off time, and improved parkinsonism, indicating that safinamide improves motor symptoms and parkinsonism without worsening dyskinesia. BlackWell Publishing Ltd 2014-02 2013-12-09 /pmc/articles/PMC4285943/ /pubmed/24323641 http://dx.doi.org/10.1002/mds.25751 Text en © 2013 The Authors. Movement Disorders published by Wiley on behalf of the International Parkinson and Movement Disorder Society. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Borgohain, Rupam Szasz, J Stanzione, P Meshram, C Bhatt, M Chirilineau, D Stocchi, F Lucini, V Giuliani, R Forrest, E Rice, P Anand, R Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations |
title | Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations |
title_full | Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations |
title_fullStr | Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations |
title_full_unstemmed | Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations |
title_short | Randomized trial of safinamide add-on to levodopa in Parkinson's disease with motor fluctuations |
title_sort | randomized trial of safinamide add-on to levodopa in parkinson's disease with motor fluctuations |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285943/ https://www.ncbi.nlm.nih.gov/pubmed/24323641 http://dx.doi.org/10.1002/mds.25751 |
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