This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Movement Disorders  • Parkinson Disease/ Parkinsonian Disorders  • Randomized Controlled Trial  • Alert me on articles by topic

The PRESTO Study

Parkinson Study Group

Arch Neurol. 2005;62:241-248.

Background  Rasagiline (N-propargyl-1[R]-aminoindan) mesylate is a novel irreversible selective monoamine oxidase type B inhibitor, previously demonstrated to improve symptoms in early Parkinson disease (PD).

Objective  To determine the safety, tolerability, and efficacy of rasagiline in levodopa-treated patients with PD and motor fluctuations.

Design  Multicenter, randomized, placebo-controlled, double-blind, parallel-group study.

Patients  Parkinson disease patients (N = 472) with at least 21/2 hours of daily "off" (poor motor function) time, despite optimized treatment with other anti-PD medications.

Interventions  Rasagiline, 1.0 or 0.5 mg/d, or matching placebo.

Main Outcome Measures  Change from baseline in total daily off time measured by patients’ home diaries during 26 weeks of treatment, percentage of patients completing 26 weeks of treatment, and adverse event frequency.

Results  During the treatment period, the mean adjusted total daily off time decreased from baseline by 1.85 hours (29%) in patients treated with 1.0 mg/d of rasagiline, 1.41 hours (23%) with 0.5 mg/d rasagiline, and 0.91 hour (15%) with placebo. Compared with placebo, patients treated with 1.0 mg/d rasagiline had 0.94 hour less off time per day, and patients treated with 0.5 mg/d rasagiline had 0.49 hour less off time per day. Prespecified secondary end points also improved during rasagiline treatment, including scores on an investigator-rated clinical global impression scale and the Unified Parkinson’s Disease Rating Scale (activities of daily living in the off state and motor performance in the "on" state). Rasagiline was well tolerated.

Conclusions  Rasagiline improves motor fluctuations and PD symptoms in levodopa-treated PD patients. In light of recently reported benefits in patients with early illness, rasagiline is a promising new treatment for PD.

Group Information: A list of the members of the Parkinson Study Group who participated in this study and were authors of this report appears above.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Transtelephonic Home Blood Pressure to Assess the Monoamine Oxidase-B Inhibitor Rasagiline in Parkinson Disease
White et al.
Hypertension 2008;52:587-593.
ABSTRACT | FULL TEXT  

Pharmacologic Options for Treatment of Levodopa-Associated ``Wearing Off''
Waters and Chen
Journal of Pharmacy Practice 2008;21:254-261.
ABSTRACT  

Tesofensine (NS 2330), a Monoamine Reuptake Inhibitor, in Patients With Advanced Parkinson Disease and Motor Fluctuations: The ADVANS Study
Rascol et al.
Arch Neurol 2008;65:577-583.
ABSTRACT | FULL TEXT  

Role of the Pharmacist in the Effective Management of Wearing-Off in Parkinson's Disease
Simonson et al.
The Annals of Pharmacotherapy 2007;41:1842-1849.
ABSTRACT | FULL TEXT  

Treatment Options in the Modern Management of Parkinson Disease
Schapira
Arch Neurol 2007;64:1083-1088.
FULL TEXT  

Ropinirole 24-hour prolonged release: Randomized, controlled study in advanced Parkinson disease
Pahwa et al.
Neurology 2007;68:1108-1115.
ABSTRACT | FULL TEXT  

New pharmacologic horizons in the treatment of Parkinson disease.
Bonuccelli and Del Dotto
Neurology 2006;67:S30-S38.
ABSTRACT | FULL TEXT  

Rationale for considering that propargylamines might be neuroprotective in Parkinson's disease
Olanow
Neurology 2006;66:S69-S79.
ABSTRACT | FULL TEXT  

Clinical trials with rasagiline: Evidence for short-term and long-term effects
Siderowf and Stern
Neurology 2006;66:S80-S88.
ABSTRACT | FULL TEXT  

Rasagiline: A second-generation monoamine oxidase type-B inhibitor for the treatment of Parkinson's disease
Chen and Ly
Am J Health Syst Pharm 2006;63:915-928.
ABSTRACT | FULL TEXT  

Safety of rasagiline in elderly patients with Parkinson disease
Goetz et al.
Neurology 2006;66:1427-1429.
ABSTRACT | FULL TEXT  

Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.
Pahwa et al.
Neurology 2006;66:983-995.
ABSTRACT | FULL TEXT  

Cost-Utility Model of Rasagiline in the Treatment of Advanced Parkinson's Disease in Finland
Hudry et al.
The Annals of Pharmacotherapy 2006;40:651-657.
ABSTRACT | FULL TEXT  

Optimizing the ongoing search for new treatments for Parkinson disease: Using futility designs
Tilley et al.
Neurology 2006;66:628-633.
ABSTRACT | FULL TEXT  

Clinical Pharmacology of Rasagiline: A Novel, Second-Generation Propargylamine for the Treatment of Parkinson Disease
Chen and Swope
J Clin Pharmacol 2005;45:878-894.
ABSTRACT | FULL TEXT  

Practice Parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.
Pahwa et al.
Neurology 2006;66:983-995.
ABSTRACT | FULL TEXT