Progression of Parkinson’s Disease and Unmet Needs in Mid- to Late-stage Patients

In early-stage Parkinson’s disease (PD), dopaminergic treatment is highly effective in controlling motor symptoms. However, as the disease progresses, other symptoms and comorbidities need to be addressed, such as suboptimal motor control, emerging motor complications (e.g. nocturnal and early-morning akinesia/tremor, early wearing-off and dyskinesia), emerging levodopa-resistant motor symptoms, increasing non-motor symptoms and treatment of non-dopaminergic symptoms. Despite these unmet needs, no new therapies for PD have been introduced into routine clinical practice over the past 10 years. Safinamide is a new oral therapy that has both dopaminergic and non-dopaminergic mechanisms of action. In phase III clinical trials, safinamide has demonstrated significant clinical benefits in patients with mid- to late-stage PD experiencing motor fluctuations as an add-on therapy to levodopa and other PD medication versus those treated only on an optimised PD therapy. This includes improvements in daily ON time, improvements in motor function and beneficial effects on dyskinesia that have been studied in patients for up to 2 years. Safinamide is well tolerated, and it is a new and unique agent in the armamentarium of treatments for patients with mid- to late-stage PD experiencing motor fluctuations.