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Published in: Advances in Therapy 4/2018

Open Access 01-04-2018 | Original Research

Long-term Efficacy of Safinamide on Parkinson’s Disease Chronic Pain

Authors: Carlo Cattaneo, Jaime Kulisevsky, Viviana Tubazio, Paola Castellani

Published in: Advances in Therapy | Issue 4/2018

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Abstract

Introduction

Chronic pain is an important yet overlooked non-motor symptom of Parkinson’s disease (PD), caused by an imbalance of the dopaminergic and glutamatergic systems. Safinamide has a multimodal mechanism of action, dopaminergic (reversible MAO-B inhibition) and non-dopaminergic (modulation of the abnormal glutamate release), that might be beneficial for both motor and non-motor symptoms.

Objectives

To investigate the long-term (2-year) efficacy of safinamide on PD chronic pain and to confirm the positive effects observed after 6 months of treatment.

Methods

This is a post hoc analysis of the data from the 2-year study 018, focused on the reduction of concomitant pain treatments and on the scores of pain-related items of the Parkinson’s disease quality of life questionnaire (PDQ-39).

Results

Safinamide, compared with placebo, significantly improved the PDQ-39 items 37 (“painful cramps or spasm,” p = 0.0074) and 39 (“unpleasantly hot or cold,” p = 0.0209) and significantly reduced the number of concomitant pain treatments by 26.2% (p = 0.005). A significantly greater proportion of patients in the safinamide group was not using pain drugs after 2 years of treatment (p = 0.0478).

Conclusions

The positive effects of safinamide on PD chronic pain were maintained in the long term. Further investigations are desirable to confirm their clinical relevance.

Funding

Zambon SpA.
Literature
1.
go back to reference Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord. 2011;26:399–406.CrossRefPubMed Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord. 2011;26:399–406.CrossRefPubMed
2.
go back to reference Wasner G, Deuschl G. Pains in Parkinson’s disease: many syndromes under one umbrella. Nat Rev Neurol. 2012;8:284–94.CrossRefPubMed Wasner G, Deuschl G. Pains in Parkinson’s disease: many syndromes under one umbrella. Nat Rev Neurol. 2012;8:284–94.CrossRefPubMed
3.
go back to reference Beiske AG, Loge JH, Rønningen A, Svennsson E. Pain in Parkinson’s disease: prevalence and characteristics. Pain. 2009;141:173–7.CrossRefPubMed Beiske AG, Loge JH, Rønningen A, Svennsson E. Pain in Parkinson’s disease: prevalence and characteristics. Pain. 2009;141:173–7.CrossRefPubMed
4.
go back to reference Cattaneo C, Barone P, Bonizzoni E, Sardina M. Effects of safinamide on pain in fluctuating Parkinson’s disease patients: a post hoc analysis. J Parkinsons Dis. 2017;7(1):95–101.CrossRefPubMedPubMedCentral Cattaneo C, Barone P, Bonizzoni E, Sardina M. Effects of safinamide on pain in fluctuating Parkinson’s disease patients: a post hoc analysis. J Parkinsons Dis. 2017;7(1):95–101.CrossRefPubMedPubMedCentral
5.
go back to reference Borgohain R, Szasz J, Stanzione P, Meshram C, et al. Two-year, randomized, controlled study of safinamide as add-on to levodopa in mid to late Parkinson’s disease. Mov Disord. 2014;29(10):1273–80.CrossRefPubMed Borgohain R, Szasz J, Stanzione P, Meshram C, et al. Two-year, randomized, controlled study of safinamide as add-on to levodopa in mid to late Parkinson’s disease. Mov Disord. 2014;29(10):1273–80.CrossRefPubMed
6.
go back to reference Borgohain R, Szasz J, Stanzione P, Meshram C, et al. Randomized trial of safinamide add-on to levodopa in Parkinson’s disease with motor fluctuations. Mov Disord. 2014;29(2):229–37.CrossRefPubMed Borgohain R, Szasz J, Stanzione P, Meshram C, et al. Randomized trial of safinamide add-on to levodopa in Parkinson’s disease with motor fluctuations. Mov Disord. 2014;29(2):229–37.CrossRefPubMed
7.
go back to reference Munazza S, Ford B. Management of pain in Parkinson’s disease. CNS Drugs. 2012;26:937–48.CrossRef Munazza S, Ford B. Management of pain in Parkinson’s disease. CNS Drugs. 2012;26:937–48.CrossRef
8.
go back to reference Parkinson J. An essay on the shaking palsy. London: Whittingham and Rowland; 1817. Parkinson J. An essay on the shaking palsy. London: Whittingham and Rowland; 1817.
9.
go back to reference Nègre-Pagès L, Regragui W, Bouhassira D, Grandjean H, Rascol O. DoPaMiP Study Group. Chronic pain in Parkinson’s disease: the cross-sectional French DoPaMiP survey. Mov Disord. 2008;23:1361–9.CrossRefPubMed Nègre-Pagès L, Regragui W, Bouhassira D, Grandjean H, Rascol O. DoPaMiP Study Group. Chronic pain in Parkinson’s disease: the cross-sectional French DoPaMiP survey. Mov Disord. 2008;23:1361–9.CrossRefPubMed
10.
go back to reference Truini A, Frontoni M, Cruccu G. Parkinson’s disease related pain: a review of recent findings. J Neurol. 2013;260:330–4.CrossRefPubMed Truini A, Frontoni M, Cruccu G. Parkinson’s disease related pain: a review of recent findings. J Neurol. 2013;260:330–4.CrossRefPubMed
11.
go back to reference Shearer J, Green C, Counsell CE, Zajicek JP. The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson’s disease. J Neurol. 2012;259:462–8.CrossRefPubMed Shearer J, Green C, Counsell CE, Zajicek JP. The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson’s disease. J Neurol. 2012;259:462–8.CrossRefPubMed
12.
go back to reference Brefel-Courbon C, Grolleau S, Thalams C, Bourrel L, et al. Comparison of chronic analgesic drugs prevalence in Parkinson’s disease, other chronic diseases and the general population. Pain. 2009;141:14–8.CrossRefPubMed Brefel-Courbon C, Grolleau S, Thalams C, Bourrel L, et al. Comparison of chronic analgesic drugs prevalence in Parkinson’s disease, other chronic diseases and the general population. Pain. 2009;141:14–8.CrossRefPubMed
13.
go back to reference Cury RG, Galhardoni R, Fonoff ET, Perez Lloret S, et al. Sensory abnormalities and pain in Parkinson disease and its modulation by treatment of motor symptoms. Eur J Pain. 2016;20:151–65.CrossRefPubMed Cury RG, Galhardoni R, Fonoff ET, Perez Lloret S, et al. Sensory abnormalities and pain in Parkinson disease and its modulation by treatment of motor symptoms. Eur J Pain. 2016;20:151–65.CrossRefPubMed
14.
go back to reference Nolano M, Provitera V, Manganelli F, Iodice R, et al. Loss of cutaneous large and small fibers in naïve and L-dopa treated PD patients. Neurology. 2017;89:776–84.CrossRefPubMed Nolano M, Provitera V, Manganelli F, Iodice R, et al. Loss of cutaneous large and small fibers in naïve and L-dopa treated PD patients. Neurology. 2017;89:776–84.CrossRefPubMed
15.
go back to reference Tinazzi M, Del Vesco C, Fincati E, Ottaviani S, Smania N, et al. Pain and motor complications in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2006;77:822–5.CrossRefPubMedPubMedCentral Tinazzi M, Del Vesco C, Fincati E, Ottaviani S, Smania N, et al. Pain and motor complications in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2006;77:822–5.CrossRefPubMedPubMedCentral
16.
go back to reference Defazio G, Berardelli A, Fabbrini G, Martino D, et al. Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol. 2008;65:1191–4.CrossRefPubMed Defazio G, Berardelli A, Fabbrini G, Martino D, et al. Pain as a nonmotor symptom of Parkinson disease: evidence from a case-control study. Arch Neurol. 2008;65:1191–4.CrossRefPubMed
17.
18.
go back to reference Kim HJ, Paek SH, Kim JY, Lee JY, et al. Chronic subthalamic deep brain stimulation improves pain in Parkinson disease. J Neurol. 2008;255(12):1889–94.CrossRefPubMed Kim HJ, Paek SH, Kim JY, Lee JY, et al. Chronic subthalamic deep brain stimulation improves pain in Parkinson disease. J Neurol. 2008;255(12):1889–94.CrossRefPubMed
19.
go back to reference Salvati P, Maj R, Caccia C, Cervini MA, Fornaretto MG, et al. Biochemical and electrophysiological studies on the mechanism of action of PNU-151774E, a novel antiepileptic compound. J Pharmacol Exp Ther. 1999;288:1151–9.PubMed Salvati P, Maj R, Caccia C, Cervini MA, Fornaretto MG, et al. Biochemical and electrophysiological studies on the mechanism of action of PNU-151774E, a novel antiepileptic compound. J Pharmacol Exp Ther. 1999;288:1151–9.PubMed
20.
go back to reference Miladinovic T, Nashed MG, Sungh G. Overview of glutamatergic dysregulation in central pathologies. Biomolecules. 2015;5:3122–41.CrossRef Miladinovic T, Nashed MG, Sungh G. Overview of glutamatergic dysregulation in central pathologies. Biomolecules. 2015;5:3122–41.CrossRef
21.
go back to reference Bleakman D, Alt A, Nisenbaum ES. Glutamate receptors and pain. Semin Cell Dev Biol. 2006;17(5):592–604.CrossRefPubMed Bleakman D, Alt A, Nisenbaum ES. Glutamate receptors and pain. Semin Cell Dev Biol. 2006;17(5):592–604.CrossRefPubMed
22.
go back to reference Rascol O, Zesiewicz T, Chaudhuri KR, Ashgarnejad M, et al. A randomized controlled exploratory pilot study to evaluate the effect of rotigotine transdermal patch on Parkinson’s disease-associated chronic pain. J Clin Pharm. 2016;56(7):852–61.CrossRef Rascol O, Zesiewicz T, Chaudhuri KR, Ashgarnejad M, et al. A randomized controlled exploratory pilot study to evaluate the effect of rotigotine transdermal patch on Parkinson’s disease-associated chronic pain. J Clin Pharm. 2016;56(7):852–61.CrossRef
23.
go back to reference Chaudhuri KR, Shapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8(5):464–74.CrossRefPubMed Chaudhuri KR, Shapira AH. Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol. 2009;8(5):464–74.CrossRefPubMed
24.
go back to reference Fox SH. Non-dopaminergic treatments for motor control in Parkinson’s disease. Drugs. 2013;73:1405–15.CrossRefPubMed Fox SH. Non-dopaminergic treatments for motor control in Parkinson’s disease. Drugs. 2013;73:1405–15.CrossRefPubMed
Metadata
Title
Long-term Efficacy of Safinamide on Parkinson’s Disease Chronic Pain
Authors
Carlo Cattaneo
Jaime Kulisevsky
Viviana Tubazio
Paola Castellani
Publication date
01-04-2018
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 4/2018
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-018-0687-z

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