[The role of inhibitors of COMT and MAO-B in the therapy of Parkinson's disease]
- PMID: 32588409
- DOI: 10.1055/a-1149-9308
[The role of inhibitors of COMT and MAO-B in the therapy of Parkinson's disease]
Abstract
Inhibitors of COMT and MAO-B are well established in the pharmacotherapy of Parkinson's disease (PD). MAO-B inhibitors are used as monotherapy as well as in combination with levodopa, whereas COMT inhibitors exert their effects only in conjungtion with levodopa. Both classes of compounds prolong the response duration of levodopa and optimise its clinical benefit. As a result, the ON-times are prolonged significantly. In the past, MAO-B inhibitors were also adminstered for neuroprotection; however, despite convincing scientific reasoning in support of neuroprotective effects, these could not be substantiated in clinical studies performed so far.
COMT- und MAO-B-Hemmer gehören neben den Dopamin-Agonisten und Levodopa zu den etablierten Pharmaka zur Behandlung des idiopathischen Parkinson-Syndroms (IPS). Die MAO-B-Hemmer Selegilin und Rasagilin entfalten auch in der Monotherapie einen symptomatischen Therapieeffekt, während Safinamid und COMT-Hemmer nur zur Kombinationstherapie mit Levodopa zugelassen sind. Beide Substanzklassen verlängern die Wirkdauer von Levodopa und optimieren die Wirkung der Therapie. Klinisch messbar resultiert eine Verlängerung der ON-Zeit. Der Einsatz von MAO-B-Inhibitoren erfolgte in der Vergangenheit auch unter der Vorstellung einer neuroprotektiven Wirkung. Trotz der aufgrund experimenteller Daten postulierten Wirkung ließ sich dieser Effekt in klinischen Studien bislang nicht zweifelsfrei belegen.
© Georg Thieme Verlag KG Stuttgart · New York.
Conflict of interest statement
Beratertätigkeit, Reisekostenerstattung, Vortragshonorare
Similar articles
-
Clinical benefit of MAO-B and COMT inhibition in Parkinson's disease: practical considerations.J Neural Transm (Vienna). 2023 Jun;130(6):847-861. doi: 10.1007/s00702-023-02623-8. Epub 2023 Mar 24. J Neural Transm (Vienna). 2023. PMID: 36964457 Free PMC article. Review.
-
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.JAMA Neurol. 2022 Feb 1;79(2):131-140. doi: 10.1001/jamaneurol.2021.4736. JAMA Neurol. 2022. PMID: 34962574 Free PMC article. Clinical Trial.
-
The inhibition of catechol O-methyltransferase and monoamine oxidase by tetralone and indanone derivatives substituted with the nitrocatechol moiety.Bioorg Chem. 2021 Sep;114:105130. doi: 10.1016/j.bioorg.2021.105130. Epub 2021 Jun 28. Bioorg Chem. 2021. PMID: 34225162
-
Pharmacologic treatment of advanced Parkinson's disease: a meta-analysis of COMT inhibitors and MAO-B inhibitors.Parkinsonism Relat Disord. 2009 Aug;15(7):500-5. doi: 10.1016/j.parkreldis.2008.12.007. Epub 2009 Jan 22. Parkinsonism Relat Disord. 2009. PMID: 19167259
-
[Enzyme inhibitors in Parkinson treatment].Pharm Unserer Zeit. 2006;35(3):218-25. doi: 10.1002/pauz.200600169. Pharm Unserer Zeit. 2006. PMID: 16724525 Review. German. No abstract available.
Cited by
-
Disruption of Dopamine Homeostasis Associated with Alteration of Proteins in Synaptic Vesicles: A Putative Central Mechanism of Parkinson's Disease Pathogenesis.Aging Dis. 2024 May 7;15(3):1204-1226. doi: 10.14336/AD.2023.0821-2. Aging Dis. 2024. PMID: 37815908 Free PMC article. Review.
-
Levodopa-Induced Dyskinesia in Parkinson's Disease: Pathogenesis and Emerging Treatment Strategies.Cells. 2022 Nov 23;11(23):3736. doi: 10.3390/cells11233736. Cells. 2022. PMID: 36496996 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
Miscellaneous