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Effectiveness of Rasagiline as a Monotherapy

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The elevated striatal dopamine levels induced by rasagiline-dependent MAO-B inhibition has been correlated to improvements in PD motor symptoms in both monotherapy and adjunctive therapy studies. The TEMPO (TVP-2012 in Early Monotherapy for Parkinson’s Disease Outpatients) study, a 26-week, randomized, double-blind and placebo-controlled clinical trial observed the efficacy of rasagiline as a monotherapy for 404 early PD patients. Efficacy of rasagiline was quantified using the Unified Parkinson’s Disease Rating Scale (UPDRS), a rating scale used to measure the progression of PD by scoring four primary categories of symptoms: mentation, behavior and mood; activities of daily living; motor examination; and complications of therapy. Higher UPDRS scores correspond to greater severity of disease with the maximum possible score of 199 points representing total disability. The patients in the TEMPO trial had a mean baseline UPDRS score of 25 points and were subsequently divided into three groups: 1 mg rasagiline qd, 2 mg rasagiline qd or placebo. At the end of the trial period, compared with the placebo group, the average change in total UPDRS score was -3.56 for the 2 mg rasagiline group and -4.20 for the 1 mg rasagiline group. Of the four UPDRS categories, the greatest change was observed in the motor examination sub-scale with a mean change of -2.71 for the 1 mg rasagiline group and -1.68 for the 2 mg rasagiline group. This reduction in UPDRS score, especially with regards to
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