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Overview : All EAI045 Advantages As well as Cons

Palhagen et?al. (77) conducted another interesting study examining the same issue, which concluded that the rate of decline of the motor UPDRS scores was significantly slower at 6?months in the patients who were treated with selegiline compared with those with placebo. The results and safety of the second MAO-B inhibitor, rasagiline was demonstrated in the TVP-1012 in Early Monotherapy for Parkinson disease Outpatients study, a randomised, double-blind, placebo-controlled trial (78). After 6?months rasagiline demonstrated significant improvement (p?<?0.001) in UPDRS score compared with placebo. Moreover, patients who were treated with rasagiline for 52?weeks showed significantly less functional decline than did patients who were treated with placebo for the first 26?weeks and then with rasagiline, a result implying a disease-modifying effect <a href="">A-1331852 mouse of rasagiline. In addition, rasagiline had an incidence of adverse events similar to placebo. It is difficult to prove that any drug is neuroprotective PLX4720 in PD as the actual number of neurons remaining in substantia nigra cannot be determined directly by any means available today. Consequently, cell survival is not a clinically relevant objective. Trials must, therefore, assess from a clinical perspective whether putative neuroprotective compounds provide favourable changes in the clinical course of PD, like attenuation of progression rate and delay of disability, e.g. disease-modifying effects (79). The delayed-start trial design is now well-accepted to be the best way to reliably assess potential disease-modifying effects without be confounded by the drug effect on symptoms (80,81). The potential disease-modifying effect of rasagiline was further explored using this study design in a large prospective delayed-start trial which included one of the earliest and largest populations studied in PD. The results of the ADAGIO study became known just EAI045 mw recently and show that a disease-modifying effect, based on the description above, was observed for rasagiline at a dose of 1?mg/day, but was not evident for the 2?mg/day dose (82,83). Newer drugs of this category have demonstrated a favourable effect in early PD patients (84,85). Safinamide (SAF) is a highly selective and reversible MAO-B inhibitor. SAF impedes both dopamine breakdown and production of toxic free radicals. It inhibits glutamate release acting as a sodium and N-type calcium channel blocker. In a placebo-controlled study 172 patients with early PD treated with a dopamine agonist, were randomised to SAF or placebo. A median SAF dose of 70?mg/day (range 40�C90?mg/day) increased the percentage of parkinsonian patients improving their motor scores by ��?30% from baseline (responders) after 3?months, from 21.4% (placebo) to 37.5% (p?<?0.05).</div>
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