Rasagiline is a second generation, selective, irreversible
monoamine oxidase type B (
MAO-B) inhibitor. It has demonstrated efficacy in monotherapy for early
Parkinson's disease (PD) patients in one large randomized, placebo-controlled trial (TVP-1012 in Early Monotherapy for
Parkinson's Disease Outpatients), and has shown ability to reduce off time in more advanced PD patients with motor fluctuations in two large placebo-controlled trials (Parkinson's
Rasagiline: Efficacy and Safety in the Treatment of "Off", and Lasting Effect in Adjunct Therapy With
Rasagiline Given Once Daily). Preclinical data abound to suggest potential for neuroprotection by this compound against a variety of neurotoxic insults in cell cultures and in animals. The lack of
amphetamine metabolites provides an advantage over the first generation
MAO-B inhibitor
selegiline. One large trial has investigated the potential for disease modification in PD patients (Attenuation of
Disease progression with
Azilect Given Once-daily) and preliminary results maintain some possible advantage to earlier initiation of the 1 mg/day dose. The clinical significance of the difference detected remains a consideration.