Combination of selegiline and controlled release levodopa in the treatment of fluctuations of clinical disability in parkinsonian patients

Chouza, C; Aljanati, R.; Scaramelli, A.; Medina, Ofrenda de; Caamaño, J.L.; Buzó, Ricardo; Fernandez, Alfredo Tavares; Romero, S

doi:10.1111/j.1600-0404.1989.tb01792.x

Cited by 12 publications

(2 citation statements)

References 7 publications

(3 reference statements)

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“…Two observational studies analyzed pre-administration and post-administration WRS score change with selegiline. Chouza et al ( 1989 ) showed a mild decrease but no significant change in WRS score after 4 months of selegiline treatment, while Ruggieri et al ( 1986 ) demonstrated significant decrease within 45 days.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis

Wang

Liu

et al. 2023

Front. Aging Neurosci.

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BackgroundDrug efficacy generally varies with different durations. There is no systematic review analyzing the effect of selegiline for Parkinson's disease (PD) on different treatment duration. This study aims to analyze how the efficacy and safety of selegiline changes for PD over time.MethodsPubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure and Wanfang Database were systematically retrieved for randomized controlled trials (RCTs) and observational studies of selegiline for PD. The search period was from inception to January 18th, 2022. The efficacy outcomes were measured by the mean change from baseline in the total and sub Unified Parkinson's Disease Rating Scale (UPDRS), Hamilton Depression Rating Scale (HAMD) and Webster Rating Scale (WRS) scores. The safety outcomes were measured by the proportion of participants having any adverse events overall and that in different system organ classes.ResultsAmong the 3,786 studies obtained, 27 RCTs and 11 observational studies met the inclusion criteria. Twenty-three studies reported an outcome which was also reported in at least one other study, and were included in meta-analyses. Compared with placebo, selegiline was found with a stronger reduction of total UPDRS score with increasing treatment duration [mean difference and 95% CIs in 1 month: −3.56 (−6.67, −0.45); 3 months: −3.32 (−3.75, −2.89); 6 months: −7.46 (−12.60, −2.32); 12 months: −5.07 (−6.74, −3.41); 48 months: −8.78 (−13.75, −3.80); 60 months: −11.06 (−16.19, −5.94)]. A similar trend was also found from the point estimates in UPDRS I, II, III, HAMD and WRS score. The results of observational studies on efficacy were not entirely consistent. As for safety, compared with placebo, selegiline had higher risk of incurring any adverse events [rate: 54.7% vs. 62.1%; odd ratio and 95% CIs: 1.58 (1.02, 2.44)], with the excess adverse events mainly manifested as neuropsychiatric disorders [26.7% vs. 31.6%; 1.36 (1.06, 1.75)] and no significant change over time. The statistically difference in overall adverse event between selegiline and active controls was not found.ConclusionSelegiline was effective in improving total UPDRS score with increasing treatment duration, and had a higher risk of incurring adverse events, especially the adverse events in the neuropsychiatric system.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO CRD42021233145.

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Section: Resultsmentioning

confidence: 99%

Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis

Wang

Liu

et al. 2023

Front. Aging Neurosci.

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“…The usefulness of L-deprenyl for suppressing the progression of this disease has already been demonstrated. It has been reported that the L-dopa (levodopa) treatment combined with L-deprenyl has reduced the side effects and prolonged parkinsonian life span as compared to treatment with levodopa alone (9). A potent and reversible MAO-B inhibitor would provide a safe adjuvant that is devoid of the hazards of unwanted side effects.…”

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confidence: 99%

A Study of the Biological Pharmacology of IFO, a New Selective and Reversible Monoamine Oxidase-B Inhibitor.

et al. 1994

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propoxy]phenyl]-5-trifluoromethyl-1,2,4-oxadiazole (IFO), design ed to be a novel selective inhibitor of monoamine oxidase (MAO), showed highly selective inhibition for type-B (MAO-B); its IC50 was approximately > 200 pM and 30 nM for type-A (MAO-A) and MAO-B, respectively, in the standard assay using mitochondrial preparations from rat brain or liver. The in vitro MAO-B inhibition by IFO was time-independent, non-competitive and tight-binding; and furthermore, in the presence of sodium cholate its inhibition was not tight-binding and was reversible. Oral administration of IFO (0.5 -100 mg/kg) produced a dose-dependent MAO-B inhibition in mouse brain; its ED50 (p.o., 1 hr) was 1.6 mg/kg, while L-deprenyl inhibited the enzyme with the ED50 of approximately 8.0 mg/kg. The ED50 for MAO-A was > 100 mg/kg for either IFO and L-deprenyl. The MAO inhibitive effect of IFO in mouse liver was the same as that in the brain, but that of L-deprenyl in mouse liver was different from that in the brain as shown by the ED50 values of 35 mg/kg and 0.6 mg/kg for MAO-A and MAO-B, respectively. In mice, IFO increased the striatal concentrations of 2-phenylethylamine (2-PEA) and showed almost the same protective efficacy as L-deprenyl against the lethality and striatal dopamine (DA) depletion induced by 1 methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). These results indicate that IFO appears to be a potent inhibitor of MAO-B in mouse brain.

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The new generation of monoamine oxidase inhibitors

Cesura

Pletscher

1992

Progress in Drug Research / Fortschritte Der Arzneimittelforschung / Progrès Des Recherches Pharmaceutiques

135

139

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Combination of selegiline and controlled release levodopa in the treatment of fluctuations of clinical disability in parkinsonian patients

Cited by 12 publications

References 7 publications

Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis

Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis

A Study of the Biological Pharmacology of IFO, a New Selective and Reversible Monoamine Oxidase-B Inhibitor.

The new generation of monoamine oxidase inhibitors

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