Safinamide in the treatment pathway of Parkinson’s Disease: a European Delphi Consensus

Abstract

Safinamide is a highly selective, reversible MAO B-inhibitor recently marketed in European and North American countries. To better define clinical indications regarding motor and non-motor symptoms, targeted population and safety of this compound, ten movement disorders specialists, experts in their field, convened and developed a panel of statements on: the role of glutamate in Parkinson’s disease, introduction to fluctuations, efficacy of safinamide on motor symptoms, motor complications and non-motor symptoms, quality of life, safety of safinamide and target population for use. Strong consensus was reached for all the statements on the efficacy of safinamide on motor symptoms, motor fluctuations, quality of life and safety. Among non-motor symptoms, a positive consensus was reached for the symptoms sleep/fatigue, mood, and pain while there was a lack of consensus for the statements regarding the efficacy of safinamide in improving cognition, urinary and sexual functions. The statement on orthostatic hypotension obtained a negative consensus. The consistent and large agreement reached in this Delphi panel perfectly reflects the perception of efficacy, safety and tolerability of safinamide as evident from pivotal trials and clinical practice and shows how these findings may guide movement disorders specialists in their clinical therapeutic approach. The impact of non-motor symptoms in PD is considerable, and management remains an unmet need. In this context, the ability of safinamide to impact some non-motor symptoms may represent the most promising and distinctive feature of this compound and deserves further investigations.

SYNAPSES. Estudio observacional europeo para evaluar la seguridad y la efectividad de la safinamida en la práctica clínica habitual: análisis post hoc de la población española del estudio

“…In a European Delphi Consensus, a panel of specialists in movement disorders from across Europe was surveyed about the performance of safinamide in PD [ 31 ]. Strong consensus was reached for all the statements regarding the efficacy of safinamide on motor symptoms, motor fluctuations, quality of life and safety.…”

Parkinson’s disease therapy: what lies ahead?

“…Safinamide, a selective, reversible MAO-B inhibitor that also reduces glutamate release by blocking voltage-dependent sodium channels and modulating calcium channels, was approved in 2015 as add-on therapy to levodopa in advanced PD patients with motor fluctuations. There is evidence to suggest that safinamide also has beneficial effects on sleep, fatigue, mood, and pain (Stocchi et al 2022 ) and it is currently investigated in advanced PD patients for its effect on sleep quality (NCT03968744).…”

Crystal structure, quantum chemical insights, and molecular docking studies of Naryl-2-(N-disubstituted) acetamide compounds: potential inhibitors for neurodegenerative enzymes

“…1), are inhibitors of the enzyme MAO-B, which plays an important role in the exacerbation of PD. 7,8 In addition, triazole derivative compounds linked to benzothiazole through an acetamide linker, 9 naphthoquinone conjugated to aryltriazole acetamide derivatives 10 and the compound N-(naphthalen-1-yl)-2-(piperidin-1)-acetamide, 11 recently reported by our group, have shown inhibitory activity against AChE and/or BChE. Furthermore, in recent studies, it has been reported that a series of compounds (R)-N-(benzo[d]thiazol-2-yl)-2-(1-phenyl-3,4-dihydroisoquinolin-2(1H)yl)acetamide showed potent specic inhibitory polypharmacological activity against MAO-B and BChE.…”