Comparison of the efficacy of Shafinamide Tablets (Siddaco) and Rasagiline, patient experience and clinical recommendations

Safinamide and rasagiline (Rasagiline) are both selective monoamine oxidases in the treatment of Parkinson's disease (PD)PD span>B inhibitors (MAO-B inhibitors) are mainly used to improve motor symptoms and prolong the effective action time of levodopa. However, there are certain differences between the two in their mechanism of action, efficacy characteristics and clinical application. An in-depth understanding of the comparative efficacy and patient experience of these two drugs can help clinicians choose a treatment plan that is more suitable for individual patients.

Safinamine tablets have a dual mechanism of action: on the one hand, as a selective MAO-B inhibitor, it can reduce the breakdown of dopamine in the brain and prolong the action time of levodopa and endogenous dopamine; on the other hand, it also has the effect of regulating the release of glutamate, thereby improving motor control and certain non-motor symptoms, such as pain and mood swings. In clinical trials, safinamine, as an adjuvant treatment with levodopa, can significantly extend the "on time", reduce the "off" phenomenon, and improve the total motor score (UPDRS Part III), which is especially suitable for patients with advanced or mid-late stage PD

In contrast, rasagiline, as a simple MAO-B inhibitor, mainly improves motor symptoms by inhibiting dopamine metabolism in the brain and increasing the effective concentration of dopamine. Its clinical application mainly focuses on early stage PD monotherapy or late stage PD combined with levodopa. Studies have shown that rasagiline can improve patients' total motor scores and delay disease progression in some patients. However, compared with safinamine, its effect on non-motor symptoms such as pain, fatigue, and mood improvement is limited.

In terms of efficacy comparison, some clinical studies and real-world data suggest that safinamide may have certain advantages in prolonging the "on" time of levodopa and improving non-motor symptoms, while rasagiline is simple and well-tolerated in early-stage PD monotherapy. Patients' experience shows that safinamine, usually combined with levodopa, can significantly improve daytime activity and reduce sudden "freezing" phenomena, but may cause mild insomnia or hypertension; rasagiline is well tolerated, convenient for daily life, and has mild side effects, but it has limited improvement in mid- and late-stage motor fluctuations.

In terms of clinical recommendations, patients with early stagePD can choose rasagiline to delay the use of levodopa if treated with monotherapy; in the middle and late stages of PDOr for patients with obvious "on-off" phenomenon, safinamine may be considered as an auxiliary drug to levodopa to improve motor fluctuations and non-motor symptoms. In terms of medication management, both must be used according to medical advice, and care should be taken to avoid simultaneous use with other MAO inhibitors or high tyramine diets to reduce the risk of elevated blood pressure or hypertensive crisis. Regular follow-up and assessment of exercise scores and quality of life can help optimize drug dosage and combination regimens to maximize efficacy.

In general, safinamide tablets and rasagiline have their own advantages: the former is effective in combined treatment and improving non-motor symptoms, and is suitable for patients with mid-to-late stage PD; the latter is well tolerated and suitable for early single drug use. The choice of which drug should be based on the patient's disease stage, motor and non-motor symptom characteristics, combined drug use and living habits, and an individualized treatment plan should be developed to achieve the best efficacy and quality of life.

Keyword tags:

Safinamide tablets, rasagiline, Parkinson's disease, MAO-B inhibitors, efficacy comparison, switch phenomenon, non-motor symptoms

Reference materials:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748321/