Long-term outcome of early versus delayed rasagiline treatment in early Parkinson's disease

Robert A. Hauser, Mark F. Lew, Howard I. Hurtig, William G. Ondo, Joanne Wojcieszek, Cheryl J. Fitzer-Attas, Frederick Marshall, Irenita Flynn Gardiner, Nancy Pearson, Debra Berry, Kathleen Shannon, Jean A. Jaglin, William Ondo, Christine Hunter, Cathy R. Anderson, Peter A. LeWitt, Patricia Kaminski, Dawn Miller, Maryan DeAngelis, Janis MiyasakiJulie So, Lisa Johnston, Caroline Tanner, Tracy Stewart, Lisa Tagg, Sheila Everett, Georgia Germain, Mickie Welsh, Micki McCollister, Linda L. Mann, Carlos Singer, William C. Koller, William J. Weiner, Dinorah Bateman, Tilak Mendis, Melodie Moterson, Cynthia Alcorn-Costa, Keely Haas, Peggy Gray, Davoud Mohtat, Neila Mendis, Laura Sutherland, Howard Hurtig, Mary Lloyd, Mary Mathews, Robert Hauser, Lisa Gauger, Patricia Dyches, Cheryl Newcomb, Kapil Dev Sethi, Karen Betcher, Carolyn C. Weeks, Sandra Kostyk, Ali H. Rajput, Marlene Gerow, Linda Klassen, Marianne Ewasnishin, Lawrence I. Golb, Vanessa Patterson, Deborah Caputo, Patricia Seuffert, Rajesh Pahwa, Tamara Gales, Lorette J. Jenkins, Amy Parsons, Scott Cradr, Jovianna N. Wellinghoff, Shantelle Coe, Mark F. Lew, Cheryl Armstrong, Connie Kawai, Katherine B. Hawthorne, Kellie Gelles, Xiaoming Lu, Suzanne W. Schuman, Cheryl Cooper, Kenneth Marek, Barbara Fussell, Karen Caplan, Erica Barnabei, Karen Stavris, Kapil D. Sethi, Joan G. Carpenter, James Osborne, Shoba Narayan, Kathy M. Ligon, Eric Molho, Sharon Evans, Jacqueline Nash, Diane Brown, Mark Stacy, Kelli Williamson, Peter Novak, Robert G. Feldman, Cathi Thomas, Wayne Martin, Pam King, Germanine McInnes, Shaunna Caouette, Joanne Wojcieszek, Jo Ann Belden, Andew Feigin, Jean Ayan, Barbara Shannon, Charles H. Adler, Stephanie Newman, Teri Radam, Myrna Schear, Naomi Santoni, Sharon Wortzel, Nancy Saton, Paul Tuite, Susan Rolandelli, Jody Lowery, Brenda J. Ebbitt, Adrienne Baranauskas, Michael J. Aminoff, Mirann DiMinno, Jessie Roth, Tracey Borst, Julie Hevezi, Carolyn Deloa, Tracey Tam, Anita Lopez, John M. Bertoni, Larisa I. Skrypnik, C. Carolyn Peterson, Mark Forrest Gordon, Roberta Winnick, Sharyn Parness, Joanne Hamann, Vincent Calabrese, Peggy Roberge, Paul R. Atchison, Cathy W. Allen, Susan Rolli, Arif Dalvi, Un Jung Kang, Judy Richman, Shirley Uy

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120 Scopus citations


The purpose of this study was to compare the long-term clinical outcome of early versus delayed rasagiline treatment in early Parkinson's disease (PD). Subjects (N = 404) were randomly assigned to initial treatment with rasagiline (early-start group) or placebo for 6 months followed by rasagiline (delayed-start group) in the TEMPO study. Subjects who chose to participate in an open-label extension (N = 306) continued to receive rasagiline as well as other PD medications as needed. Average (±SD) duration in the study was 3.6 ± 2.1 years; 177 subjects received rasagiline for ≥5.0 years. Over the entire 6.5-year follow-up period, the adjusted mean difference in change from baseline in total UPDRS scores was 2.5 units (SE 1.1; P 5 0.021) or 16% (SE 5.7; P 5 0.006) in favor of the early-start versus delayed-start rasagiline group. Although the interaction between treatment and time was signi.cant, values for the early-start group were better than the delayed-start group across all time points. Significantly less worsening (percent change) in total UPDRS scores was observed in the early-start group at the time points 0.5, 1.5, 2.0, 3.0, 4.5, 5.0, and 5.5 years (P < 0.05). Compared to delayed start, early initiation of rasagiline provided long-term clinical benefit, even in the face of treatment with other dopaminergic agents. This might re.ect enduring benefits due to neuroprotection or effects on compensatory mechanisms in early PD.

Original languageEnglish (US)
Pages (from-to)564-573
Number of pages10
JournalMovement Disorders
Issue number4
StatePublished - Mar 15 2009


  • Disease modification
  • MAO-B inhibitor
  • Parkinson's disease
  • Rasagiline
  • Treatment neuroprotection

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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