Effects of rasagiline on olfactory function in patients with Parkinson's disease

Haehner, Antje; Hummel, Thomas; Wolz, Martin; Klingelhöfer, Lisa; Fauser, Mareike; Storch, Alexander; Reichmann, Heinz

doi:10.1002/mds.25661

Cited by 21 publications

(14 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25 The current study included olfaction as an exploratory variable because rasagiline was demonstrated to ameliorate olfactory deficits in an alpha-synuclein mouse model of PD (although improvements in olfactory bulb neurogenesis were not identified) 26 and was associated with significant improvement in olfaction in PD patients in an open-label study. 27 However, a recent double-blind, placebo-controlled study reported no significant olfactory improvements with rasagiline, 28 and our results were also negative.…”

Section: Discussioncontrasting

confidence: 68%

Randomized, controlled trial of rasagiline as an add‐on to dopamine agonists in Parkinson's disease

Hauser

Silver²,

Choudhry

et al. 2014

Movement Disorders

View full text Add to dashboard Cite

A B S T R AC T : Dopamine agonists (DA) are often used as first-line monotherapy for the symptomatic control of Parkinson's disease (PD). However, DA monotherapy typically becomes inadequate within a few years, at which time the DA dosage must be increased or other antiparkinsonian medications added. Adding a monoamine oxidase-B (MAO-B) inhibitor to DA monotherapy might improve symptomatic control while maintaining good safety and tolerability. We conducted an 18-week, randomized, double-blind, placebo-controlled trial of rasagiline 1 mg/d as an add-on to DA therapy (ropinirole 6 mg/d or pramipexole 1.0 mg/d) in early PD patients whose conditions were not adequately controlled on their current treatment regimen. The primary efficacy variable was the change in total Unified Parkinson Disease Rating Scale (UPDRS) score (sum of parts I, II, and III) from baseline to week 18, comparing rasagiline and placebo groups. The modified intent-to-treat (ITT) population included 321 subjects whose mean 6 SD age was 62.6 6 9.7, and duration of PD was 2.1 6 2.1 years. Results demonstrated a significantly greater improvement in total UPDRS scores from baseline to week 18 in the rasagiline group compared with the placebo group (least squares [LS] mean difference 6 SE, 22.4 6 0.95; 95% confidence interval [CI], 24.3, 20.5; P 5 0.012). Mean improvement (LS mean 6 SE) was 23.6 6 0.68 in the rasagiline group and 21.2 6 0.68 in the placebo group. Rasagiline was well tolerated, and the most common adverse events (AEs; rasagiline vs. placebo) were dizziness (7.4% vs. 6.1%), somnolence (6.8% vs. 6.7%), and headache (6.2% vs. 4.3%). Rasagiline 1 mg/d provided statistically significant improvement when added to dopamine agonist therapy and was well tolerated.

show abstract

Section: Discussioncontrasting

confidence: 68%

Randomized, controlled trial of rasagiline as an add‐on to dopamine agonists in Parkinson's disease

Hauser

Silver²,

Choudhry

et al. 2014

Movement Disorders

View full text Add to dashboard Cite

show abstract

“…In an open-label study in 17 PD patients using the University of Pennsylvania Smell Identification Test (Doty et al 1984a), rasagiline was associated with significant improvement in olfaction (Alvarez and Grogan 2012). However, our own results of an 18-weeks, randomized double-blind, placebo-controlled study of rasagiline as add-on or monotherapy in 34 patients missed the level of significance in orthonasal, retronasal, and electrophysiological olfactory score differences (Haehner et al 2013a). The primary endpoint of the study did not change significantly, secondary analyses however, were indicative of a treatment effect.…”

Section: Introductionmentioning

confidence: 61%

“…However, the lack of improvement in the brief odor identification test used in the study by Hauser et al (2014) might be explained by the specific effect of rasagiline on odor discrimination abilities, and the possible inhomogeneity in disease duration of the patients. The latter also applies to our prospective study (Haehner et al 2013a), which included patients up to a disease duration of 10 years with altogether only a small number of cases.…”

Section: Discussionmentioning

confidence: 99%

Early Parkinson’s disease patients on rasagiline present with better odor discrimination

et al. 2015

Self Cite

View full text Add to dashboard Cite

The effects of rasagiline on olfaction in animal studies are convincing. However, apart from various anecdotal patient reports, they could not be reproduced in prospective studies in humans. Cross-sectional data of large patient groups are still missing. The aim of this study was therefore to determine the olfactory function in a broad heterogeneous Parkinson's disease (PD) population with and without rasagiline intake. In this single-center, cross-sectional study 224 PD patients with and without rasagiline (1 mg/day) participated. Seventy-four of them received rasagiline as mono, or adjunct therapy. One-hundred fifty patients were untreated or received PD medication other than rasagiline. Comprehensive olfactory testing was performed for phenyl-ethyl alcohol odor thresholds, odor discrimination, and odor identification. Olfactory function did not differ between the two treatment groups with disease duration up to 29 years. Rasagiline-treated patients with disease duration of less than 8 years, however, presented with significant better odor discrimination abilities compared to PD patients without rasagiline treatment. This effect was no longer evident in patients with longer disease duration and proofed to be independent of age, sex, and medication. Our results may suggest that rasagiline treatment has a positive effect on the processing of olfactory information in early PD.

show abstract

“…While hyposmia is not a target of PD treatment per se, antiparkinsonian medications have no effect on olfaction dysfunction [13, 14]. It has been proposed that deep brain stimulation (DBS) may indirectly affect olfaction; however, most large randomized DBS studies have not utilized an olfaction outcome measure, and the few DBS studies that have reported an olfaction outcome have been conducted on relatively small sample sizes and have yielded conflicting results [15–18].…”

Section: Introductionmentioning

confidence: 99%

Aerobic Exercise Preserves Olfaction Function in Individuals with Parkinson’s Disease

Rosenfeldt

Dey

Alberts

2016

Parkinson's Disease

View full text Add to dashboard Cite

Introduction. Based on anecdotal reports of improved olfaction following aerobic exercise, the aim of this study was to evaluate the effects of an 8-week aerobic exercise program on olfaction function in individuals with Parkinson's disease (PD). Methods. Thirty-eight participants with idiopathic PD were randomized to either an aerobic exercise group (n = 23) or a nonexercise control group (n = 15). The aerobic exercise group completed a 60-minute cycling session three times per week for eight weeks while the nonexercise control group received no intervention. All participants completed the University of Pennsylvania Smell Identification Test (UPSIT) at baseline, end of treatment, and a four-week follow up. Results. Change in UPSIT scores between the exercise and nonexercise groups from baseline to EOT (p = 0.01) and from baseline to EOT+4 (p = 0.02) favored the aerobic exercise group. Individuals in the nonexercise group had worsening olfaction function over time, while the exercise group was spared from decline. Discussion. The difference in UPSIT scores suggested that aerobic exercise may be altering central nervous system pathways that regulate the physiologic or cognitive processes controlling olfaction in individuals with PD. While these results provide promising preliminary evidence that exercise may modify the disease process, further systematic evaluation is necessary.

show abstract

Effects of rasagiline on olfactory function in patients with Parkinson's disease

Abstract: The primary end point of the study was not reached, and therefore, a specific effect of rasagiline on olfactory function in PD could not be demonstrated.

Cited by 21 publications

References 31 publications

Randomized, controlled trial of rasagiline as an add‐on to dopamine agonists in Parkinson's disease

Randomized, controlled trial of rasagiline as an add‐on to dopamine agonists in Parkinson's disease

Early Parkinson’s disease patients on rasagiline present with better odor discrimination

Aerobic Exercise Preserves Olfaction Function in Individuals with Parkinson’s Disease

Contact Info

Product

Resources

About