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Rasagiline as an adjunct to Levodopa in patients with Parkinson's disease and motor fluctuations

Management of patients with complications of Parkinson's disease remains a challenge for both the clinician and the patient.
These complications may be a result of the natural course of the disease itself, or can be related to the treatments. Most patients receiving chronic Levodopa therapy may manifest motor fluctuations, defined as periods of the day with poor or absent motor response to their medication ( off-time ) alternating with periods of clearly improved motor function ( on-time ).

Preliminary data showed that the additional use of Rasagiline may be useful in the treatment of advanced Parkinson's disease.

Rasagiline ( Agilect ) is a novel drug for Parkinson's disease with selective, irreversible monoamine oxidase B ( MAO-B ) inhibitor activity, and is effective as monotherapy in early disease.

The researchers recruited 687 patients: 231 individuals were assigned to receive 1 mg of oral Rasagiline once daily, 227 to Entacapone ( 200 mg with every Levodopa dose ) and 229 to a placebo.

Both Rasagiline and Entacapone reduced average daily off-time ( -1•18 h for Rasagiline and -1•2 h for Entacapone ) when compared with placebo.

Frequency of adverse events was similar for all treatments.

This study has shown that Rasagiline is an effective, safe and simple treatment for Parkinson's disease when used in combination with Levodopa.
Rasagiline achieved the two main goals of treatment after Levodopa - reduced disability and decreased motor fluctuations.
These properties position the drug as a favourable candidate to add to the treatment of Parkinson's disease.

Source: The Lancet, 2005


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