Selegiline (10mg) used once daily as adjunct to levodopa therapy significantly delayed the progression of parkinsonian symptoms (tremor and limb rigidity) compared to the use of levodopa alone. Further, the activities of daily living were significantly better in the selegiline+levodopa group. The better symptom control was achieved with lower daily dose of levodopa in the selegiline+levodopa group compared to patients receiving levodopa alone. In addition, the patients on adjunct selegiline begun to experience wearing-off later than patients on levodopa alone. The side-effects related to the use of selegiline, such as nausea, were mild and typical for compounds that increase the dopamine levels in the brain.
In this study the patients with early disease were randomly assigned to first receive selegiline or placebo as monotherapy and the combination therapy with levodopa was introduced with the advancement of the symptoms of the disease. The patients were followed for seven years or until other dopaminergic therapies were introduced to control the symptoms of the disease. Selegiline 10mg once daily used as monotherapy, significantly delayed the need to initiate levodopa treatment compared to placebo.
"Results of this long-term study strengthen the position of selegiline in the treatment of Parkinson's disease, either as monotherapy or in conjunction with levodopa therapy", said Sven Pålhagen, Neurologist of Karolinska University Hospital, Huddinge, Sweden.
The results of this exceptionally long follow-up study confirm earlier study findings indicating that selegiline slows down the progression of the signs and symptoms of Parkinson's disease.
About Selegiline
Selegiline is a selective inhibitor of the monoamine oxidase type B (MAO-B). In the brain, MAO-B is responsible for the breakdown of dopamine. By inhibiting the MAO-B, the breakdown of dopamine can be decreased in the brain, and the symptoms of the disease can be improved. Selegiline has also been shown to have neuroprotective effects in numerous experimental in vitro and in vivo models.
In the early phase of the disease, selegiline has been shown to significantly delay the need to initiate levodopa therapy. In later phases of the disease, selegiline has been shown to reduce the fluctuations in clinical disability related to use of levodopa therapy.
About Parkinson's Disease
Parkinson's disease is a chronic and progressive neurological condition that affects 6.3 million people worldwide. One out of 100 people over age 60 and one per 50 people over age 80 suffer from this disease.
While its cause is unknown, PD symptoms are primarily the result of degeneration of dopaminergic neurons in the substantia nigra, a part of the brain that controls and modulates movement.
Symptoms include tremor, slowness of movement, stiffness and rigidity of limbs and gait or balance problems. As the disease progresses, these symptoms usually increase and impact a person's ability to work and function.
About Orion Pharma
Orion Pharma is a research and development-orientated pharmaceutical division of the Orion Group (HEX:ORNAS, ORNBS), which is one of the leading companies in the healthcare sector in the Nordic area of Europe. Pharmaceutical R&D at Orion Pharma focuses on three core therapy areas: CNS, central nervous system, CCC, cardiology and critical care, and HTU, hormonal therapies and urology. Orion Pharma has been particularly devoted to the development of therapies for Parkinson's Disease. Selegiline, launched in 1982 as Eldepryl®, was the first pharmaceutical compound, which Orion Pharma developed for PD. Orion Pharma is also the originator of entacapone (Comtess® /Comtan®) and Stalevo®, a novel levodopa treatment which combines three active compounds in one tablet.
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Selegiline Modifies Disease Progression in Early Parkinson Patients. Results of the 7-year double-blind study: S. Pålhagen and the Swedish Parkinson Study Group, Karolinska University Hospital, Huddinge, Sweden.
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Pålhagen S, Heinonen EH, Hägglund J, Kaugesaar T, Kontants H, Mäki-Ikola O, et al. Selegiline delays the onset of disability in de novo parkinsonian patients. Swedish Parkinson Study Group. Neurology 1998;51(2):520-525.
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