Uma análise comparativa entre o uso de fármacos inibidores da Monoamino oxidase-B e Levodopa na Doença de Parkinson

Autores

  • Eduardo Fernandes Portes Unifoa
  • Caio Miranda de Oliveira Unifoa
  • Rafael Angelo Pinto de Souza Unifoa
  • Júlia Rezende Godinho Carvalho Unifoa
  • Maria Vit´ória da Silva Tomaz
  • Lívia de Moraes Ribeiro Meirelles
  • Pedro Henrique Costa Diniz Unifoa
  • Walter Luiz M. Sampaio da Fonseca Unifoa

Palavras-chave:

Discinesisas, Doença de Parkinson, Dopamina, Sistema nervoso central

Resumo

A Doença de Parkinson é a segunda afecção neurodegenerativa mais prevalente em idosos, caracterizada pela perda de neurônios dopaminérgicos. Casos sintomáticos da doença têm como tratamento preferencial a utilização da Levodopa ou de algum agonista dopaminérgico. Entretanto, a monoterapia baseada no uso desses agentes está sujeita a queda progressiva da eficácia, dessa forma a adição de fármacos adjuvantes para mitigar este efeito é prática comum. Para tal, são utilizados inibidores de catecol-O-metiltransferase e inibidores da monoamino oxidase-B. Nesse contexto, os autores objetivam identificar novidades relacionadas à monoterapia ou à terapêutica adjuvante com inibidores da monoamino oxidase-B. Foi conduzida uma análise qualitativa de 18 artigos abordando novidades no tratamento sintomatológico da Doença de Parkinson, obtidos através do banco de dados PubMed, utilizando-se do critério de busca por mesh terms "(Parkinson Disease[MeSH Terms]) AND (inhibitors, monoamine oxidase[MeSH Terms])", associado aos filtros “artigos produzidos nos últimos 10 anos”, “ensaios clínicos” e “ensaios clínicos randomizados”. Ao longo do texto foram discutidas as novidades terapêuticas recentes dos fármacos da classe dos inibidores da monoamino oxidase-B no contexto da monoterapia ou terapia adjuvante para a doença de Parkinson. O artigo conclui que a utilização de dois fármacos da classe dos inibidores da monoamino oxidase-B, a Rasagilina e a Safinamida, obtiveram resultados em ensaios clínicos recentes que corroboram sua eficácia como adjuvantes ao padrão terapêutico principal com Levodopa.

Referências

ABBRUZZESE, G. et al. A European observational study to evaluate the safety and the effectiveness of safinamide in routine clinical practice: The SYNAPSES trial. Journal of Parkinson’s disease, v. 11, n. 1, p. 187–198, 2021.

CATTANEO, C.; JOST, W. H.; BONIZZONI, E. Long-term efficacy of safinamide on symptoms severity and quality of life in fluctuating Parkinson’s disease patients. Journal of Parkinson’s disease, v. 10, n. 1, p. 89–97, 2020.

ELMER, L. W. Rasagiline adjunct therapy in patients with Parkinson’s disease: post hoc analyses of the PRESTO and LARGO trials. Parkinsonism & related disorders, v. 19, n. 11, p. 930–936, 2013.

FRAKEY, L. L.; FRIEDMAN, J. H. Cognitive effects of rasagiline in mild-to-moderate stage Parkinson’s disease without dementia. The journal of neuropsychiatry and clinical neurosciences, v. 29, n. 1, p. 22–25, Inverno 2017.

GRAY, R. et al. Long-term effectiveness of adjuvant treatment with catechol-O-methyltransferase or monoamine oxidase B inhibitors compared with dopamine agonists among patients with Parkinson disease uncontrolled by levodopa therapy: The PD MED randomized clinical trial: The PD MED randomized clinical trial. JAMA neurology, v. 79, n. 2, p. 131–140, 2022.

HAUSER, R. A. et al. Longer duration of MAO-B inhibitor exposure is associated with less clinical decline in Parkinson’s disease: An analysis of NET-PD LS1. Journal of Parkinson’s disease, v. 7, n. 1, p. 117–127, 2017.

HATTORI, N. et al. Efficacy and safety of adjunctive rasagiline in Japanese Parkinson’s disease patients with wearing-off phenomena: A phase 2/3, randomized, double-blind, placebo-controlled, multicenter study. Parkinsonism & related disorders, v. 53, p. 21–27, 2018.

HATTORI, N. et al. Rasagiline monotherapy in early Parkinson’s disease: A phase 3, randomized study in Japan. Parkinsonism & related disorders, v. 60, p. 146–152, 2019.

HATTORI, N. et al. Efficacy and safety of safinamide as an add-on therapy to L-DOPA for patients with Parkinson’s disease: A randomized, double-blind, placebo-controlled, phase II/III study. Parkinsonism & related disorders, v. 75, p. 17–23, 2020.

MASELLIS, M. et al. Dopamine D2 receptor gene variants and response to rasagiline in early Parkinson’s disease: a pharmacogenetic study. Brain: a journal of neurology, v. 139, n. Pt 7, p. 2050–2062, 2016.

MCINTOSH, E. et al. Cost-effectiveness of dopamine agonists and monoamine oxidase B inhibitors in early Parkinson’s disease. Movement disorders: official journal of the Movement Disorder Society, v. 36, n. 9, p. 2136–2143, 2021.

PD MED COLLABORATIVE GROUP et al. Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson’s disease (PD MED): a large, open-label, pragmatic randomised trial. Lancet, v. 384, n. 9949, p. 1196–1205, 2014.

POEWE, W. et al. Effects of rasagiline on the progression of nonmotor scores of the MDS-UPDRS: Effect of Rasagiline on Nonmotor Symptoms. Movement disorders: official journal of the Movement Disorder Society, v. 30, n. 4, p. 589–592, 2015.

STOCCHI, F.; ADAGIO INVESTIGATORS. Benefits of treatment with rasagiline for fatigue symptoms in patients with early Parkinson’s disease. European journal of neurology: the official journal of the European Federation of Neurological Societies, v. 21, n. 2, p. 357–360, 2014.

WANG, M. et al. Pharmacokinetics, pharmacodynamics, and safety of a single escalating dose and repeated doses of rasagiline transdermal patch in healthy Chinese subjects. Clinical pharmacology in drug development, v. 9, n. 5, p. 602–609, 2020.

WEINTRAUB, D. et al. Rasagiline for mild cognitive impairment in Parkinson’s disease: A placebo-controlled trial. Movement disorders: official journal of the Movement Disorder Society, v. 31, n. 5, p. 709–714, 2016.

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Publicado

04-08-2023

Como Citar

Fernandes Portes, E., Miranda de Oliveira, C., Angelo Pinto de Souza, R., Rezende Godinho Carvalho, J., da Silva Tomaz, M. V., de Moraes Ribeiro Meirelles, L., Costa Diniz, P. H., & M. Sampaio da Fonseca, W. L. (2023). Uma análise comparativa entre o uso de fármacos inibidores da Monoamino oxidase-B e Levodopa na Doença de Parkinson . Congresso Médico Acadêmico UniFOA. Recuperado de https://conferencias.unifoa.edu.br/congresso-medvr/article/view/349

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