This study from the Parkinson’s Study Group indicates rasagiline should benefit persons with very early Parkinson’s disease. These benefits seem modest, and are similar to those observed with another MAO-B inhibitor, selegiline. The impact that rasagiline has on symptoms, as quantified by the UPDRS rating scale, was not greater than that reported from studies of L-dopa/carbidopa and dopamine agonists. Thus, although rasagiline could prove helpful to particular individuals with very mild Parkinson’s disease, it seems on the basis of this trial alone that rasagiline will not have a marked impact on how Parkinson’s disease is currently treated in these patients. It probably won’t affect the debate over whether treatment initiation should emphasize L-dopa/carbidopa or a dopamine agonist. Still, in the study rasagiline was well tolerated, and the question of whether there is a neuroprotective benefit remains unanswered. If longer term studies show its benefits to persist over time in the Parkinson’s patient, it would likely then have a more influential role on Parkinson’s...  Read more

This study from the Parkinson’s Study Group indicates rasagiline should benefit persons with very early Parkinson’s disease. These benefits seem modest, and are similar to those observed with another MAO-B inhibitor, selegiline. The impact that rasagiline has on symptoms, as quantified by the UPDRS rating scale, was not greater than that reported from studies of L-dopa/carbidopa and dopamine agonists. Thus, although rasagiline could prove helpful to particular individuals with very mild Parkinson’s disease, it seems on the basis of this trial alone that rasagiline will not have a marked impact on how Parkinson’s disease is currently treated in these patients. It probably won’t affect the debate over whether treatment initiation should emphasize L-dopa/carbidopa or a dopamine agonist. Still, in the study rasagiline was well tolerated, and the question of whether there is a neuroprotective benefit remains unanswered. If longer term studies show its benefits to persist over time in the Parkinson’s patient, it would likely then have a more influential role on Parkinson’s management, and spur interest in its evaluation for other neurodegenerative disorders, in particular Alzheimer’s disease. Also, it is still possible that niche uses will be found for rasagiline in which it turns out to be quite useful.

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