A new analysis of multiple studies suggests that for Asian people with Parkinson's disease who have motor fluctuations, adding safinamide 100 mg to levodopa may work better than adding rasagiline or zonisamide. The analysis looked at data from 2,824 patients and compared how well these drugs reduced daily OFF-time (when Parkinson's symptoms return) and improved motor function.
The results showed that safinamide 100 mg was superior to rasagiline 1 mg and zonisamide 25 mg for both reducing OFF-time and improving motor scores. For example, safinamide reduced OFF-time by about half an hour more than rasagiline. However, when compared to zonisamide 50 mg, the benefits of safinamide were not statistically significant, meaning the difference could be due to chance.
Safety information was not reported in this analysis, so it is unclear if there were any side effects. Also, the analysis did not include selegiline because no eligible studies were found. This is a network meta-analysis, which combines results from different studies, but it does not prove that one drug is better for everyone.
For Asian Parkinson's patients with motor fluctuations, safinamide 100 mg may be a more effective add-on to levodopa than rasagiline or zonisamide 25 mg. However, patients should discuss with their doctor which medication is best for their individual situation.
