Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease

Caslake, Robert; Macleod, Angus; Ives, Natalie; Stowe, Rebecca; Counsell, Carl

doi:10.1002/14651858.cd006661.pub2

Cited by 41 publications

(27 citation statements)

References 21 publications

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“…Compared with levodopa and dopamine agonists, the symptomatic relief of early PD provided by MAO-B inhibitors is modest at best [10]; however, they are associated with fewer side effects [11]. A study investigating monotherapy of rasagiline compared with ropinirole and pramipexole in early PD concluded that patients receiving rasagiline experienced fewer adverse events and dropout rates were lower than with those receiveing the dopamine agonists.…”

Section: Monoamine Oxidase-b (Mao-b) Inhibitorsmentioning

confidence: 99%

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Robakis

Fahn

2015

CNS Drugs

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Inhibitors of monoamine oxidase-B (MAO-B) occupy an important place in the treatment of Parkinson's disease. Selegiline was the first MAO-B to be used therapeutically, while rasagiline is a second-generation drug with higher potency and selectivity. Safinamide is an investigational MAO-B inhibitor with non-dopaminergic properties that may provide advantages over its predecessors. As a class, MAO-B inhibitors are safe and well tolerated and provide symptomatic benefit both as monotherapy and in combination with other antiparkinsonian medications from early to late stages of disease. In combination with levodopa, MAO-B inhibitors may improve motor fluctuations and allow for lower total doses of levodopa. Patient characteristics and preferences can be important factors in deciding between agents. As a class, MAO-B inhibitors have shown promise as disease-modifying agents, but the clinical trial evidence to date has not been strong enough to afford them such a label. Future research may help further elucidate their relative merits and clarify their role in altering disease progression. Key PointsRasagiline and selegiline are two monoamine oxidase-B (MAO-B) inhibitors commonly used in the treatment of Parkinson's disease (PD), while safinamide is an investigational agent of the same class.MAO-B inhibitors are safe, with few serious side effects, and provide mild but worthwhile improvements in the motor symptoms of PD, either as monotherapy or adjunctive to levodopa.The possibility that MAO-B inhibitors could slow down the progression of PD has been suggested by some studies but not by others and remains an open question.

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Section: Monoamine Oxidase-b (Mao-b) Inhibitorsmentioning

confidence: 99%

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Robakis

Fahn

2015

CNS Drugs

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“…One of the metaanalyses that reported the funding source of included RCTs 47 used an ad hoc method to assess study quality that did not include an assessment of study funding. Five meta-analyses 34,44,[60][61][62] used at least 3 of the 6 domains from the Cochrane Risk of Bias tool, which does not produce a single quality score, but rather provides ratings for individual risk components. 63 Only 1 of the 5 meta-analyses 62 reported the funding source of included RCTs, but it did not include this information in the assessment of risk of bias.…”

Section: Reporting Of Disclosed Cois From Rcts Included In Meta-analysesmentioning

confidence: 99%

“…37,38,40,44,47,54,60 In 4 of these 7 meta-analyses, 37,44,54,60 100% of included RCTs that reported study funding were funded by the pharmaceutical industry. Only 1 of the 7 metaanalyses, however, provided information on study funding of included RCTs, 47 and that was done in a table footnote.…”

Section: Reporting Of Disclosed Cois From Rcts Included In Meta-analysesmentioning

confidence: 99%

Reporting of Conflicts of Interest in Meta-Analyses of Trials of Pharmacological Treatments

Roseman¹,

Milette²,

Bero³

et al. 2011

Survey of Anesthesiology

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“…The magnitude of these side effects depends on the duration of treatment, duration of the disease, type of drug, and combination of drugs used [2]. While side effects of antiparkinsonian therapy are mostly related to the use of levodopa (L-dopa), dopamine agonists (DA), monoamine oxidase inhibitors (MAOBI), anticholinergics, amantadine, and catechol-O-methyl transferase inhibitors (COMTI) have also been implicated [3] [4] [5] [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Medication Side Effect Profiles in PD Patients in a Safety-Net Hospital

Sisniega¹,

Madhusudhan²,

Rahmani³

et al. 2017

APD

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Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson's disease (PD) medication side effects.These are yet to be examined in relation to race and level of education. The goal of this analysis was to identify socioeconomic or clinical variables that are associated with compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in patients in a safety-net hospital. Methods: A movement disorder patient database containing 452 patients with idiopathic PD was analyzed for differences in PD medication side effects using univariate and multivariate logistic regression analysis. Race, sex, and level of education were evaluated as possible confounders. Results: A greater proportion of the patients in this study were Caucasian males. The only variable associated with compulsive behavior was age, with higher age having a protective effect (p = 0.0336). Disease duration (defined as time since the onset of symptoms), diagnosis duration (time since formal diagnosis), and level of education were significantly associated with dyskinesia inunivariate analysis (p =< 0.0001, <0.0001, 0.1236 respectively). However, diagnosis duration was the only variable significantly associated with dyskinesia in multivariate analysis (p = 0.0038), in addition to a borderline significant association when comparing individuals with graduate degree to those who had completed high school education or less (p = 0.0599), with a protective effect of higher education. Disease duration, diagnosis duration, and use of monoamineoxidase inhibitors were also significantly associated with motor fluctuations in the univariate analysis, while only diagnosis duration was significantly associated with motor fluctuations in multivariate analysis (p = 0.0035) with longer diagnosis duration associated with higher risk of motor fluctuations. Age, disease duration, and diagnosis duration were associated with an increased risk of hallucinations

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Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease

Cited by 41 publications

References 21 publications

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Reporting of Conflicts of Interest in Meta-Analyses of Trials of Pharmacological Treatments

Medication Side Effect Profiles in PD Patients in a Safety-Net Hospital

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