Confirmed: No Slowing of Parkinson's Progression With Rasagiline

movementdisorders.onlinelib...

[Bolt_Upright]

Here is a better link: movementdisorders.onlinelib...

Conclusions

We found no evidence that 1 mg/day rasagiline has a disease-modifying effect in PD over 1 year. We found pSN free-water increased over 1 year, and baseline free-water relates to clinical motor progression, demonstrating the importance of diffusion imaging parameters for detecting and predicting PD progression. © 2021 International Parkinson and Movement Disorder Society

[Dap1948]

So, correct me if I’m wrong, but there are no medications which are believed to slow progression now? The

[Hidden in reply to Dap1948]

Hi Dap1948:

Depending on who you ask, that was true before this current research. 10 years ago the US FDA concluded that "there was insufficient evidence of a disease modifying benefit with rasagiline." [see page 114 in Dr Ahlskog's book]

[Dap1948 in reply to Hidden]

Presumably the same goes for selegiline?

[Hidden in reply to Dap1948]

Yes, and he says:

excerpt from Dr. Ahlskog's book

[LeharLover62]

Too bad. I remember we had more hope when my husband started Azilect over a decade ago.

[eschneid]

Not the greatest news, but better to know and move on....

[Fumaniron]

I’m sure this won’t stop those who anecdotally feel it’s helping them already from continuing to take..

[johntPM]

As I understand it, this research says nothing about the symptomatic benefits of rasagiline.

Rasagiline is a MAO-B inhibitor which means that it makes dopamine last longer. A dose of 1 mg of rasagiline has, approximately, a levodopa equivalent dose of 100 mg.

Rasagiline has the useful feature that its half-life is long enough for a daily dose to give an almost constant benefit. Roughly speaking, C/L which has a short half-life of about 90 minutes, gives a period of effectiveness of about 4 hours. Equating the area under the curve, implies that rasagiline gives a continuous benefit equivalent to 100 x 4 / 24 = 16 mg of levodopa. For many this is not noticeable, but it is still there, working in the background.

Unfortunately, the most rasagiline that can be taken per day is about 1 mg.

[Despe in reply to johntPM]

John,

For my husband, it caused confusion. Doctor said to discontinue it.

[Sherry1960]

I was on for a short time as it caused me cardiac problems. I was advised to discontinue it.