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Rasagiline: A Review of Its Use in the Treatment of Idiopathic Parkinson’s Disease

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Abstract

Rasagiline (Azilect®) is an oral, second-generation, selective, irreversible monoamine oxidase-B (MAO-B) inhibitor approved in the US for the treatment of Parkinson’s disease. In randomized, controlled trials, oral rasagiline 1 mg once daily was superior to placebo in the symptomatic treatment of early Parkinson’s disease, both as monotherapy or as an adjunct to dopamine agonists. Comparisons of early-start and delayed-start treatment suggested a disease-modifying effect for rasagiline, but the results were equivocal. Rasagiline 0.5 or 1 mg/day was also superior to placebo as adjunctive therapy to levodopa in Parkinson’s disease patients with motor fluctuations. Rasagiline was generally well tolerated in clinical trials, displaying a placebo-like tolerability profile in several studies. Cost-utility studies predicted that rasagiline, either as monotherapy or adjunctive therapy, would be a cost-effective treatment option. Therefore, oral rasagiline is a valuable therapeutic option for use in all stages of Parkinson’s disease.

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Disclosure

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit. Paul McCormack is a salaried employee of Adis/Springer.

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    Paul L. McCormack

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  1. Paul L. McCormack
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Correspondence to Paul L. McCormack.

Additional information

The manuscript was reviewed by: J. J. Chen, Movement Disorders Center, Loma Linda University, Loma Linda, CA, USA; S. Fahn, Department of Neurology, Columbia University Medical Center, New York, NY, USA; W. H. Jost, Parkinson-Klinik Wolfach, Wolfach, Germany; M. Naoi, Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin, Aichi, Japan; D. Robakis, Department of Neurology, Columbia University Medical Center, New York, NY, USA; M. B. H. Youdim, Technion-Rappaport Faculty of Medicine, Eve Topf Center of Excellence, Technion Israel Institute of Technology, Haifa, Israel; S. Zambito Marsala, Department of Neurology, San Martino Hospital, Belluno, Italy.

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McCormack, P.L. Rasagiline: A Review of Its Use in the Treatment of Idiopathic Parkinson’s Disease. CNS Drugs 28, 1083–1097 (2014). https://doi.org/10.1007/s40263-014-0206-y

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