Department of Pharmacy Practice, School of Pharmacy, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia.
School of Postgraduate Studies, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia.
Int J Environ Res Public Health. 2021 Dec 30;19(1):364. doi: 10.3390/ijerph19010364.
Parkinson's Disease (PD) is a disease that involves neurodegeneration and is characterised by the motor symptoms which include muscle rigidity, tremor, and bradykinesia. Other non-motor symptoms include pain, depression, anxiety, and psychosis. This disease affects up to ten million people worldwide. The pathophysiology behind PD is due to the neurodegeneration of the nigrostriatal pathway. There are many conventional drugs used in the treatment of PD. However, there are limitations associated with conventional drugs. For instance, levodopa is associated with the on-off phenomenon, and it may induce wearing off as time progresses. Therefore, this review aimed to analyze the newly approved drugs by the United States-Food and Drug Administration (US-FDA) from 2016-2019 as the adjuvant therapy for the treatment of PD symptoms in terms of efficacy and safety. The new drugs include safinamide, istradefylline and pimavanserin. From this review, safinamide is considered to be more efficacious and safer as the adjunct therapy to levodopa as compared to istradefylline in controlling the motor symptoms. In Study 016, both safinamide 50 mg ( = 0.0138) and 100 mg ( = 0.0006) have improved the Unified Parkinson's Disease Rating Scale (UPDRS) part III score as compared to placebo. Improvement in Clinical Global Impression-Change (CGI-C), Clinical Global Impression-Severity of Illness (CGI-S) and off time were also seen in both groups of patients following the morning levodopa dose. Pimavanserin also showed favorable effects in ameliorating the symptoms of Parkinson's Disease Psychosis (PDP). A combination of conventional therapy and non-pharmacological treatment is warranted to enhance the well-being of PD patients.
帕金森病（PD）是一种涉及神经退行性变的疾病，其特征是运动症状，包括肌肉僵硬、震颤和运动迟缓。其他非运动症状包括疼痛、抑郁、焦虑和精神病。这种疾病影响了全球多达 1000 万人。PD 的病理生理学是由于黑质纹状体通路的神经退行性变。有许多传统药物用于治疗 PD。然而，传统药物存在局限性。例如，左旋多巴与开-关现象有关，随着时间的推移，它可能会引起药效减退。因此，本综述旨在分析 2016 年至 2019 年期间美国食品和药物管理局（US-FDA）批准的新药物，作为治疗 PD 症状的辅助疗法，从疗效和安全性方面进行评估。新药物包括沙芬酰胺、依曲茶碱和匹莫范色林。从本综述来看，与依曲茶碱相比，沙芬酰胺作为左旋多巴的辅助疗法，在控制运动症状方面更有效、更安全。在研究 016 中，与安慰剂相比，沙芬酰胺 50mg（=0.0138）和 100mg（=0.0006）均改善了统一帕金森病评定量表（UPDRS）第三部分评分。两组患者在清晨左旋多巴剂量后，临床总体印象变化量表（CGI-C）、临床总体印象严重程度量表（CGI-S）和停药时间也有所改善。匹莫范色林也显示出改善帕金森病精神病（PDP）症状的有利效果。需要结合常规治疗和非药物治疗，以提高 PD 患者的生活质量。
