Pramipexole versus selegiline in patients with Parkinson’s disease : an effectiveness and safety (EAS)‎ analysis

Abstract EN

Background: Levodopa treatment is the gold standard in Parkinson’s disease but has the risk of dyskinesias.

Selegiline delays the introduction of levodopa and pramipexole is used as a symptomatic treatment in Parkinson’s disease.

Objectives: This study aimed to compare the effectiveness of pramipexole with selegiline in Parkinson’s disease patients.

Methods: Data regarding motor and cognitive impairments and plasma phospholipids of 500 Chinese patients with confirmed Parkinson’s disease from medical records of 1 January 2015 to 1 June 2016 were retrospectively evaluated.

Patients received either pramipexole (PP cohort, n = 250) or selegiline (SG cohort, n = 250).

Also, data regarding hospitalization, adverse effects, and expenditure were collected and analyzed from records of the follow-up period.

Results: After 3-years of treatments, selegiline and pramipexole both improved motor and cognitive impairments and decreased plasma phospholipid levels (P < 0.05 for all).

The intensity of improvement in motor and cognitive impairments and a decrease in the level of plasma phospholipids for pramipexole was higher than those of selegiline (P < 0.05 for all).

Pramipexole caused muscle weakness (P = 0.015) and peripheral edema (P = 0.0004).

While, selegiline caused cardiovascular disease (P = 0.008).

Higher numbers of patients in the SG cohort were hospitalized during 3-years of treatment than those in PP cohort (11 vs.

1, P = 0.009).

Selegiline treatment is more expensive than pramipexole (4,457 ± 345 ¥ vs.

3,649 ± 301 ¥/patient/year, P < 0.0001).

Conclusions: Pramipexole treatment may have better improvement in motor and cognitive impairments than selegiline with neuroprotective action and manageable side effects (Level of Evidence: III).