Summary of Consensus and Strategic Perspectives
Summary of Consensus and Strategic Perspectives
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This final section synthesizes the general conclusions of the expert panel, addressing the central question regarding the positioning of Safinamide in the therapeutic algorithm, and extracts the most salient knowledge for clinical practice and communication of its attributes.
When should Safinamide be considered as the primary complementary therapy to Levodopa?
When should Safinamide be considered as the primary complementary therapy to Levodopa?
The panel's final consensus is that safinamide should be considered as a complementary therapy of choice in patients with Parkinson's disease who experience both motor and non-motor fluctuations. Its dual action profile makes it an ideal option for optimizing comprehensive treatment, allowing multiple symptoms (motor, pain, mood) to be addressed with a single molecule. Moreover, it is presented as a potential alternative to consider before a dopamine agonist, particularly in patients with neuropsychiatric risk profiles or in older adults.
Key insights
Key insights
A synthesis of the discourse among experts reveals four overarching insights that delineate the clinical significance of Safinamide:
Comprehensive management: It is posited that safinamide functions as a comprehensive optimizer for patients who experience fluctuations, employing a holistic approach that addresses both motor and non-motor symptoms concurrently. These non-motor symptoms include, but are not limited to, pain and mood disturbances, such as apathy and motivation.
Dose-driven benefit: The administration of a 100-mg dose instigates a dual mechanism of action (dopaminergic and antiglutamatergic), thereby offering a precise and rational benefit for the management of chronic pain in patients with Parkinson's disease.
Superior safety profile in sleep: A notable property of safinamide is its neutral safety profile with respect to sleep, which eliminates the risk of excessive daytime sleepiness or the exacerbation of REM sleep behavior disorder induced by other drugs, such as agonists.
Principle of therapeutic optimization: This approach aligns with the clinical principle of "treating as many symptoms as possible with as few drugs as possible." In the context of fluctuating patients with non-motor comorbidities, the administration of safinamide has been demonstrated to optimize outcomes.
Explanatory note: The following report summarizes the perspectives, comments, and opinions expressed, as well as those reflected in the working matrices, by the panel of specialists during the "I Experts Meeting: Safinamide and Quality of Life (Evidence/Local Experiences)” held in Cartagena, Colombia, on September 13, 2025.
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