Rasagiline improves quality of life in patients with early Parkinson's disease

Abstract

The objective of this study was to determine the effects of rasagiline as monotherapy on quality of life (QOL) in patients with early Parkinson's disease (PD). Rasagiline, a potent, second-generation, irreversible, selective monoamine oxidase B inhibitor improves PD symptoms in patients with early PD. Patients with early untreated PD were randomly assigned to once-daily rasagiline 1 mg/day, rasagiline 2 mg/day, or placebo in a 6-month, double-blind trial (n=404). At the end of 6 months, patients entered the preplanned, active-treatment phase in which those receiving 1 mg/day and 2 mg/day of rasagiline continued on their previously assigned dosages and those receiving placebo switched to rasagiline 2 mg/day, while maintaining blinding to treatment assignments. QOL was measured with the Parkinson's Disease Quality of Life questionnaire (PDQUALIF) at 0, 14, 26, and 52 weeks after randomization. Analysis of the change in PDQUALIF scores from baseline to 6 months showed adjusted treatment effects (with 95% confidence interval) favoring rasagiline over placebo of -2.91 units (-5.19, -0.64, P=0.01) for the 1 mg/day group and -2.74 units (-5.02, -0.45, P=0.02) for the 2 mg/day. Subscore analysis attributed most of this benefit to the self-image/sexuality domain. At 12 months (n=266), with all groups receiving rasagiline for at least 6 months, no significant differences in PDQUALIF scores were seen between groups. Rasagiline improved QOL compared with placebo. This QOL improvement appears to be accounted for primarily by the symptomatic benefit of rasagiline.

Two questionnaires for Parkinson’s disease: are the PDQ-39 and PDQL equivalent?

“…The PDQ-39 and PDQL are generally accepted as valid HRQoL measures for PD [11,15,40,41] and have therefore been included as a variable of interest or outcome in clinical research [5][6][7][8][9][10]. To our knowledge, however, there is no study that has sought to compare the psychometric attributes of these scales when simultaneously applied to the same population.…”

“…In PD, HRQoL has been studied from different standpoints [1,2,[4][5][6] and is frequently included as a primary or secondary end point in clinical trials [7][8][9][10]. At least eight PD-specific HRQoL measures have been developed since 1995 [11,12].…”

Rasagiline Promotes Regeneration of Substantia Nigra Dopaminergic Neurons in Post-MPTP-induced Parkinsonism via Activation of Tyrosine Kinase Receptor Signaling Pathway

“…brainÀderived neurotrophic factor (BDNF)), bioenergetics (coenzyme Q10) and the novel antiÀParkinson drug rasagiline (Azilect1; NÀpropar-gylÀ1(R)Àaminoindan), a second generation selective inhibitor of monoamine oxidase (MAOÀB) [3,4]. Rasagiline is a promising new drug for PD in light of lately reported benefits in PD patients with early illness [5,6]. Recent multiÀcenter doubleÀblind monoÀtherapy with rasagiline by the Parkinson Study Group [5] and as adjunct therapy to LÀDOPA [7] have shown that rasagiline confers significant symptomatic improvement.…”

Effects of rasagiline on freezing of gait in Parkinson's disease - an open-label, multicenter study

“…In a placebo-controlled study in early PD (ref. 12 ), rasagiline monotherapy resulted in a significant improvement in self-image/sexuality domain subscore and global QoL measured on the PD-QUALIF. In our study in PD patients with FoG on add-on therapy with rasagiline, we observed an improvement in global PDQ-39 score and the scores of three subscales, with a particularly marked improvement for the mobility subscale.…”