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Table 2 Major trials for selegiline and rasagiline

From: Monoamine oxidase-B (MAO-B) inhibitors: implications for disease-modification in Parkinson’s disease

Selegiline Rasagiline
DATATOP 1993 [13] TEMPO 2004 [31]
Study design RCT selegiline vs. placebo Study design Randomized, delayed start trial rasagiline for 1 year vs. 6 months placebo then 6 months rasagiline
Participants 800 patients Participants 404 patients
Follow up period 2 years Follow up period 1 year
End point Functional disability requiring levodopa End point Change in UPDRS score
Major finding Need for levodopa delayed by 9 months in the selegiline group Major finding Slower disease deterioration in the early start rasagiline group
Conclusion Symptomatic benefit Conclusion Symptomatic benefit
Possible disease-modifying effect
SELEDO 1999 [19] PRESTO 2005 [28]
Study design RCT selegiline vs. placebo, as adjunct to levodopa Study design RCT rasagiline vs. placebo, as adjunct to levodopa
Participants 116 patients Participants 472 patients with daily off time
Follow up period 5 years Follow up period 26 weeks
End point Increase in >50% of initial levodopa dose End point Total daily off time
Major finding Primary end point delayed in the selegiline group Major finding Less off time in the rasagiline group
Conclusion Symptomatic benefit as adjunct to levodopa Conclusion Symptomatic benefit as adjunct to levodopa
Larsen 1999 [17] LARGO 2005 [29]
Study design RCT selegiline vs. placebo, as adjunct to madopar. 1 month wash out of selegiline at the end of study period Study design RCT rasagiline vs. entacapone vs. placebo, as adjunct to levodopa
Participants 163 patients Participants 687 patients with daily off time
Follow up period 5 years Follow up period 18 weeks
End point Levodopa requirement and deterioration of UPDRS score End point Total daily off time
Major finding Lower levodopa requirement and UPDRS score in the selegiline group Major finding Less off time in the rasagiline group
Conclusion Symptomatic benefit as adjunct to madopar Conclusion Symptomatic benefit as adjunct to levodopa
Possible disease-modifying effect
Palhagen 2006 [16] ADAGIO 2009 [35]
Study design RCT selegiline vs. placebo, as adjunct to levodopa Study design Randomized, delayed start trial rasagiline for 72 weeks vs. 36 weeks placebo then 36 weeks rasagiline
Participants 140 patients Participants 1176 patients
Follow up period 7 years Follow up period 72 weeks
End point Deterioration of UPDRS score End point Three hierarchical end points to indicate significant disease-modification
Major finding Slower disease deterioration in the selegiline group Major finding Rasagiline 1 mg/day achieved all three hierarchical end points, but not in 2 mg/day dose
Conclusion Symptomatic benefit as adjunct to levodopa Conclusion Possible disease-modifying effect