Spanish expert consensus on the use of safinamide in Parkinson's disease

Neurologia (Engl Ed). 2018 Jul 30:S0213-4853(18)30172-5. doi: 10.1016/j.nrl.2018.04.007. Online ahead of print.
[Article in English, Spanish]

Abstract

Safinamide is a new add-on drug to levodopa for the treatment of Parkinson's disease (PD) with motor fluctuations. Due to the recent incorporation of safinamide into routine clinical practice, no post-authorisation phase IV studies on the safety of safinamide have been conducted to date. This study provides clinical management guidelines for safinamide based on the opinion of a group of experts in movement disorders. This project was developed in 2 phases: 16 local meetings in phase 1 and a national meeting in phase 2. The meetings followed a pre-established agenda. The present clinical practice guidelines are based on the main conclusions reached during the national meeting. The group concluded that safinamide is effective in reducing motor and non-motor fluctuations. PD patients with mild-to-moderate fluctuations benefit most from treatment, although the drug may also improve the clinical status of patients with advanced PD. The dose of other dopaminergic drugs may be reduced after introducing safinamide, which would contribute to reducing such adverse reactions as impulse control disorder. At doses higher than those usually prescribed, safinamide may also improve dyskinesia. The experts agreed that safinamide is well tolerated and causes few adverse reactions when compared with placebo.

Keywords: Discinesias; Dyskinesia; Fluctuaciones; Fluctuations; Glutamate; Glutamato; Inhibidores de la MAO; MAO-B inhibitors; Parkinson; Safinamida; Safinamide.