Should We Add Safinamide to Levodopa for Parkinson Disease?

On time without troublesome dyskinesia was longer with safinamide than with placebo in a phase III trial. Its role relative to existing therapies remains unclear.

Safinamide is a Parkinson disease (PD) medication that acts on the dopaminergic and non-dopaminergic systems. The mechanisms of action include making dopamine more available by blocking the enzyme monoamine oxidase B (MAO-B), blocking sodium and potassium channels, and reducing glutamate release. Safinamide is not currently FDA approved (but other MAO-B drugs are).

In this double-blind, manufacturer-supported phase III study, investigators compared safinamide to placebo in 549 PD patients already on levodopa therapy and experiencing >1.5 hours per day of off time. Off time was defined as the patient perception that PD medications failed to kick in and was measured by a validated diary. PD drug regimens were optimized and held stable for 1 mo…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)