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Safety comparisons among monoamine oxidase inhibitors against Parkinson's disease using FDA adverse event reporting system

Monoamine oxidase B (MAO-B) inhibitors are used to control Parkinson's disease (PD). Selegiline, rasagiline, and safinamide are widely used as MAO-B inhibitors worldwide. Although these drugs inhibit MAO-B, there are pharmacological and chemical differences, such as the inhibitory activity, the non-dopaminergic properties in safinamide, and the amphetamine-like structure in selegiline. MAO-B inhibitors may differ in adverse events (AEs). However, differences in actual practical clinics are not fully investigated. A retrospective study was conducted using FAERS, the largest database of spontaneous adverse events. AE signals for MAO-B inhibitors, including selegiline, rasagiline, and safinamide, were detected using the reporting odds ratio method and compared. Hypocomplementemia, hepatic cyst, hepatic function abnormal, liver disorder and cholangitis were detected for selegiline as drug-specific signals. The amphetamine effect was not confirmed for any of the three MAO-B inhibitors. The tyramine reaction was detected as an AE signal only for rasagiline. Moreover, the REM sleep behavior disorder was not detected as an AE signal for safinamide, suggesting that non-dopaminergic effects might be beneficial. Considering the differences in AEs for MAO-B inhibitors will assist with the appropriate PD medication.

 

Comments:

Absolutely, understanding the differences in adverse events (AEs) associated with MAO-B inhibitors is crucial for prescribing appropriate medications for Parkinson's disease (PD) patients. The study you mentioned sheds light on the unique pharmacological and safety profiles of these drugs.

Selegiline, while effective in inhibiting MAO-B, has been associated with specific AEs like hypocomplementemia, hepatic cysts, and hepatic function abnormalities. Its chemical structure, resembling amphetamine, might contribute to these distinct side effects.

On the other hand, rasagiline showed an AE signal for tyramine reaction, indicating caution in dietary considerations. Meanwhile, safinamide, with its non-dopaminergic properties, didn't show signals for certain AEs like REM sleep behavior disorder, potentially indicating some advantages in this regard over the others.

These findings suggest that while all these medications act as MAO-B inhibitors, their chemical and pharmacological differences might lead to varying adverse effects. Such insights are crucial for clinicians to tailor treatments based on individual patient profiles, considering not just the therapeutic effects but also the potential side effects and tolerability.

Further investigation and clinical studies could provide deeper insights into the clinical implications of these differences, helping clinicians make more informed decisions when selecting the most suitable MAO-B inhibitor for PD patients.

Related Products

Cat.No. Product Name Information
S1472 Safinamide Mesylate Safinamide Mesylate (PNU-151774E, FCE28073) is mesylate salt of Safinamide, selectively and reversibly inhibits MAO-B with IC50 of 98 nM, exhibits 5918-fold selectivity against MAO-A. Phase 3.

Related Targets

MAO