Monoamine Oxidase Type B Inhibitors in the Treatment of Early Parkinson’s Disease

US Neurology ◽  
2010 ◽  
Vol 06 (01) ◽  
pp. 36
Author(s):  
Cherian Abraham Karunapuzha ◽  
Shilpa Chitnis ◽  
Richard B Dewey ◽  
◽  
◽  
...  
Keyword(s):  
Monoamine Oxidase ◽  
Clinical Evidence ◽  
Advanced Disease ◽  
Symptom Expression ◽  
Type B ◽  
Disease Modifying Drugs ◽  
Mao B ◽  
Early Parkinson’S Disease ◽  
Monoamine Oxidase Type B

Therapy in Parkinson’s disease (PD) needs to be individualized since patients differ in symptom expression and responsiveness to pharmacotherapy. Disease-modifying drugs should be considered early in the course of the disease, but none is currently US Food and Drug Administration (FDA)-approved for this indication. Symptomatic therapies should be optimized to keep the patient independent and functioning for as long as possible. Early therapies in PD consist of dopamine agonists, monoamine oxidase type B (MAO-B) inhibitors, and, in some patients, carbidopa–levodopa (depending on age and symptom severity). MAO-B inhibitors are approved by the FDA for monotherapy in treatment of early PD and as an adjunct to levodopa in advanced disease. This article focuses on the role of MAO-B enzymes in PD pathogenesis and reviews clinical evidence for the use of MAO-B inhibitors in the treatment of early PD.

scholarly journals Comparative effectiveness of dopamine agonists and monoamine oxidase type-B inhibitors for Parkinson’s disease: a multiple treatment comparison meta-analysis

2020 ◽  
Vol 76 (12) ◽  
pp. 1731-1743
Author(s):  
Caroline D. Binde ◽  
Ingunn F. Tvete ◽  
Jørund I. Gåsemyr ◽  
Bent Natvig ◽  
Marianne Klemp
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Monoamine Oxidase ◽  
Comparative Effectiveness ◽  
Dopamine Agonists ◽  
Relative Effectiveness ◽  
Type B ◽  
Mao B ◽  
Treatment Comparison ◽  
Monoamine Oxidase Type B

Abstract Purpose To investigate the comparative effectiveness of dopamine agonists and monoamine oxidase type-B (MAO-B) inhibitors available for treatment of Parkinson’s disease. Methods We performed a systematic literature search identifying randomized controlled trials investigating 4 dopamine agonists (cabergoline, pramipexole, ropinirole, rotigotine) and 3 MAO-B inhibitors (selegiline, rasagiline, safinamide) for Parkinson’s disease. We extracted and pooled data from included clinical trials in a joint model allowing both direct and indirect comparison of the seven drugs. We considered dopamine agonists and MAO-B inhibitors given as monotherapy or in combination with levodopa. Selected endpoints were change in the Unified Parkinson’s Disease Rating Scale (UPDRS) score, serious adverse events and withdrawals. We estimated the relative effectiveness of each dopamine agonist and MAO-B inhibitor versus comparator drug. Results Altogether, 79 publications were included in the analysis. We found all the investigated drugs to be effective compared with placebo when given as monotherapy except safinamide. When considering combination treatment, the estimated relative effects of selegiline, pramipexole, ropinirole, rotigotine, cabergoline, rasagiline and safinamide were 2.316 (1.819, 2.951), 2.091 (1.889, 2.317), 2.037 (1.804, 2.294), 1.912 (1.716, 2.129), 1.664 (1.113, 2.418), 1.584 (1.379, 1.820) and 1.179 (1.031, 1.352), respectively, compared with joint placebo and levodopa treatment. Conclusions Dopamine agonists were found to be effective as treatment for Parkinson’s disease, both when given as monotherapy and in combination with levodopa. Selegiline and rasagiline were also found to be effective for treating Parkinson’s disease, and selegiline was the best option in combination with levodopa among all the drugs investigated.

scholarly journals Monoamine oxidase type B inhibitors in early Parkinson's disease: meta-analysis of 17 randomised trials involving 3525 patients

BMJ ◽  
2004 ◽  
Vol 329 (7466) ◽  
pp. 593 ◽  
Author(s):  
Natalie J Ives ◽  
Rebecca L Stowe ◽  
Joanna Marro ◽  
Carl Counsell ◽  
Angus Macleod ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Monoamine Oxidase ◽  
Meta Analysis ◽  
Type B ◽  
Randomised Trials ◽  
Early Parkinson’S Disease ◽  
Monoamine Oxidase Type B

scholarly journals Application of Assay of Platelet Monoamine Oxidase Type-B (MAO-B) Activity to the Discrimination of Selegiline Use from Methamphetamine Abuse

2003 ◽  
Vol 49 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Munehiro Katagi ◽  
Hiroe Tsutsumi ◽  
Michiaki Tatsuno ◽  
Tohru Kamata ◽  
Hiroshi Nishioka ◽  
...  
Keyword(s):  
Monoamine Oxidase ◽  
Type B ◽  
Methamphetamine Abuse ◽  
Mao B ◽  
Platelet Monoamine Oxidase ◽  
Monoamine Oxidase Type B

Pharmacologic Management of Parkinson Disease: Choice of Initial Therapy in Early Disease

2008 ◽  
Vol 21 (4) ◽  
pp. 244-253 ◽  
Author(s):  
Jack J. Chen ◽  
Rajesh Pahwa
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Monoamine Oxidase ◽  
Dopamine Agonists ◽  
Initial Therapy ◽  
Motor Complications ◽  
Type B ◽  
Early Parkinson’S Disease ◽  
Monoamine Oxidase Type B

The most efficacious symptomatic agent for Parkinson's disease is levodopa; however, the development of motor complications with long-term therapy is concerning. In the modern day treatment of Parkinson's disease, non-levodopa agents (eg, dopamine agonists, monoamine oxidase type B inhibitors) should be considered as appropriate initial treatments. In early Parkinson's disease, dopamine agonists provide effective symptomatic therapy, reduce the risk for motor complications, and delay the need to initiate levodopa. However, the dopamine agonists are associated with impulse control disorders and behaviors that are concerning. Monoamine oxidase type B inhibitors are also effective as monotherapy for early stage Parkinson's disease. Clinical data demonstrate that early initiation of rasagiline (in the absence of functional impairment) is associated with improved outcomes as opposed to delayed initiation. Selegiline can delay the need for levodopa, albeit its clinical effectiveness as monotherapy is equivocal. When selecting initial therapy for early Parkinson's disease, clinicians must consider both short-term and long-term benefits and risks.

Sign in / Sign up

Export Citation Format

Share Document