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Safinamide from daily clinical practice: first clinical steps

J. Pagonabarraga-Mora, J. Kulisevsky [REV NEUROL 2017;65:433-438] PMID: 29130466 DOI: https://doi.org/10.33588/rn.6510.2017050

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Volumen 65 | Number 10 | Nº of views of the article 10.782 | Nº of PDF downloads 504 | Article publication date 16/11/2017

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ABSTRACT

INTRODUCTION The management of motor complications in Parkinsons disease (PD) is still limited. Safinamide, a new drug that has MAO-B inhibition and antiglutamatergic effects through inhibition of sodium channels, has shown efficacy for the treatment of fluctuations at doses of 50-100 mg/day.

PATIENTS AND METHODS From daily clinical practice, we describe the efficacy and tolerability of safinamide at three months in PD patients with motor complications. Efficacy was assessed by the Clinical Global Impression of Change scale and change in off time during the daytime. All reported adverse events were recorded.

RESULTS Fifty patients were recruited. 57.4% reported to be much better or moderately better at three months, improving both motor and non-motor fluctuations. Significant decrease of 0.9 ± 0.6 h/day was achieved at three months. In 13 patients (27.6%), levodopa equivalent daily dose was reduced in 132 mg/day. In patients with dyskinesias, safinamide 100 mg/day was better for controlling fluctuations and dyskinesias. 19% of patients had mild adverse events. Seven patients stopped treatment after development of confusional syndrome.

CONCLUSIONS The dopaminergic and non-dopaminergic action of safinamide exerts a good control of motor fluctuations. In patients with fluctuations and dyskinesias the dose of 100 mg/day of safinamide is preferred. Tolerability was good, except for patients older than 75 years or in advanced stages of the disease. KeywordsDyskinesias Fluctuations MAO-B inhibitors Parkinson Safinamide CategoriesNeurodegeneración Trastornos del movimiento

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Original

Safinamide from daily clinical practice: first clinical steps