[Rasagiline is not for all Parkinson disease patients: the ADAGIO study].
Rasagiline is a MAO-B inhibitor that is currently registered for the symptomatic treatment of Parkinson disease. The ADAGIO trial studied the potential disease-modifying properties of rasagiline in 1100 patients with Parkinson disease, using an innovative 'delayed start' design. Patients were randomized to either immediate treatment or delayed treatment (after 9 months). Two doses of rasagiline were studied: 1 or 2 mg. Both doses relieved the symptoms. However, the group that immediately started on 1 mg showed an extra improvement at the end of follow-up. This could not be explained by the effect on the symptoms, but was possibly a disease-modifying effect. Surprisingly, the 2 mg group did not show this additional effect at the end of follow-up. Therefore no definite conclusions can be drawn with respect to the potential disease-modifying properties of rasagiline. Rasagiline should be prescribed only with the aim of symptomatic relief, but not to curb the progression of Parkinson disease.
Universitair Medisch Centrum Groningen, afd. Neurologie, Groningen, the Netherlands. t.van.laar@neuro.umcg.nl
Teus
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van Laar
Agnita J W
AJ
Boon
Bastiaan R
BR
Bloem
D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D007189:Indans; D008996:Monoamine Oxidase Inhibitors; C031967:rasagiline