Safinamide mesylate

As a selective monoamine oxidase B (MAO-B) inhibitor, XADAGO offers a unique mechanism of action that complements traditional therapies, potentially improving motor function and reducing "off" time in patients. The increasing prevalence of Parkinson's disease and the growing demand for effective therapies create a substantial market opportunity for XADAGO, particularly in regions with aging populations. LAS VEGAS, April 22, 2025 /PRNewswire/ -- DelveInsight's " XADAGO/EQUFINA Market Size, Forecast, and Market Insight Report" highlights the details around XADAGO/EQUFINA, an inhibitor of monoamine oxidase B (MAO-B) indicated as an adjunctive treatment to levodopa/carbidopa in patients with Parkinson's disease experiencing "off" episodes. The report provides product descriptions, patent details, and competitor products (marketed and emerging therapies) of XADAGO/EQUFINA. The report also highlights the historical and forecasted sales from 2020 to 2034 segmented into 7MM [the United States, the EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan]. Newron Pharmaceuticals/Eisai/Meiji Seika Pharma's XADAGO/EQUFINA (safinamide) Overview XADAGO is a monoamine oxidase B (MAO-B) inhibitor used alongside levodopa/carbidopa to help manage "off" episodes in individuals with Parkinson's disease. While its exact mode of action in treating Parkinson's is not fully understood, it is thought to work by inhibiting MAO-B, thereby reducing dopamine breakdown. This leads to increased dopamine levels and enhanced dopaminergic activity in the brain. XADAGO contains the active ingredient safinamide in the form of a mesylate salt and is available in 50 mg and 100 mg film-coated oral tablets. Each tablet provides either 65.88 mg or 131.76 mg of safinamide mesylate, equivalent to 50 mg or 100 mg of the safinamide base. The medication is marketed as XADAGO in the United States and Europe and under the name EQUFINA in Japan. Learn more about XADAGO/EQUFINA projected market size for Parkinson's disease @ XADAGO/EQUFINA Market Potential Parkinson's disease is a progressive neurological disorder that mainly impairs movement control. It results from the slow degeneration of dopamine-producing neurons in the brain, especially in the substantia nigra, a region crucial for managing voluntary motor function. According to estimates by DelveInsight, there were 2.7 million diagnosed prevalent cases of Parkinson's disease in the 7MM in 2023, with the United States accounting for around 45% of these cases. While a cure for Parkinson's remains elusive, a combination of pharmacological and non-pharmacological therapies is used to manage symptoms. Physical, occupational, and speech therapies form key components of treatment, and surgical procedures may benefit select patients. Additionally, complementary therapies are sometimes employed to help address particular symptoms. Frequently prescribed medications for Parkinson's include levodopa, dopamine agonists, MAO-B inhibitors, COMT inhibitors, amantadine, anticholinergics, and adenosine A2A antagonists. These treatments primarily target motor symptoms, which are a major concern for those affected. DelveInsight reports that the Parkinson's disease market in the 7MM was valued at USD 3.2 billion in 2023. The market is expected to grow over the forecast period (2020–2034), fueled by the launch of new therapies, increasing prevalence, better access to healthcare, and rising demand for more advanced and effective treatment options. Discover more about the Parkinson's disease market in detail @ Parkinson's Disease Market Report Emerging Competitors of XADAGO/EQUFINA Some of the drugs in the pipeline include Solengepras (Cerevance), Minzasolmin (UCB Biopharma SRL/Novartis), Buntanetap (Annovis Bio), and others. Buntanetap has successfully completed Phase III trials for early-stage Parkinson's disease. Annovis Bio has scheduled a meeting with the FDA in Q1 2025 to determine the development path forward for Buntanetap in the treatment of Parkinson's disease. Buntanetap is also being developed for Alzheimer's disease, Lewy Body Dementia, and other neurodegenerative disorders. In November 2024, Cerevance announced the dosing of the first patient in its pivotal Phase III ARISE trial, evaluating solengepras as a potential adjunctive treatment for Parkinson's disease. Cerevance expects to report topline data in the first half of 2026. In December 2021, UCB partnered with Novartis to globally co-develop and co-commercialize UCB0599, a pioneering alpha-synuclein misfolding inhibitor currently in Phase II clinical trials for Parkinson's disease. To know more about the number of competing drugs in development, visit @ XADAGO/EQUFINA Market Positioning Compared to Other Drugs Key Milestones of XADAGO/EQUFINA In April 2020, Newron Pharmaceutical acknowledged that US WorldMeds, who held the US commercialization rights for the licensed drug, XADAGO, as a sub licensee of Zambon, had entered into a definitive agreement with Supernus Pharmaceuticals under which Supernus would acquire the CNS portfolio of US WorldMeds, including the US rights to XADAGO In November 2019, Eisai announced that it had launched the EQUFINA 50mg tablets for the indication of improvement of the wearing-off phenomenon in patients with Parkinson's disease under treatment with a drug containing levodopa in Japan. Manufacturing and marketing approval of EQUFINA was obtained in September 2019. In April 2017, Eisai Co., Ltd. and Meiji Seika Pharma announced entering into a license agreement for the commercialization of safinamide (development code: ME2125) to treat Parkinson's disease in Japan and Asia. In March 2017, Newron Pharmaceuticals announced the US FDA approval of XADAGO to treat Parkinson's disease as an add-on therapy to levodopa/carbidopa for patients experiencing "off" episodes. In March 2016, Zambon announced a strategic agreement with US WorldMeds to commercialize Newron's lead compound, XADAGO, to treat Parkinson's disease in the US. In February 2015, XADAGO was approved in the European Union as an add-on therapy to levodopa, alone or in combination with other Parkinson's medications, in mid-late stage PD patients with motor fluctuations. XADAGO/EQUFINA Patent Details XADAGO tablets are currently protected by three XADAGO patents with US patent numbers 8,076,515, 8,278,485, and 8,283,380, which expire between June 2027 and December 2028 and are listed in the FDA's publication, Approved Drug Products with Therapeutic Equivalence Evaluations, commonly referred to as the Orange Book. The company has a license agreement with Zambon S.p.A., Newron's partner, related to the XADAGO Patents, and as a new chemical entity, XADAGO is under the 5-year FDA exclusivity period that expires on March 21, 2022. In May 2017, Zambon filed a worldwide patent under the patent number WO2017207587A1. The invention relates to pharmaceutical compositions comprising safinamide and, more particularly, to taste-masked particles comprising said active ingredient or pharmaceutically acceptable salts thereof, oral dosage forms that include said particles, and a process for preparing them. Discover how XADAGO/EQUFINA is shaping the Parkinson's disease treatment landscape @ XADAGO 50mg XADAGO/EQUFINA Market Dynamics XADAGO, marketed as EQUFINA in some regions (notably in South Korea and Japan), is a once-daily oral selective MAO-B inhibitor used as an add-on treatment for Parkinson's disease patients experiencing "off" episodes while on a stable dose of levodopa. The drug's unique dual mechanism of action—MAO-B inhibition and modulation of glutamate release—offers both dopaminergic and non-dopaminergic effects, positioning it as a differentiated product in the PD adjunctive therapy landscape. This has helped it carve a niche in markets where patients are inadequately controlled by levodopa alone, particularly those in mid-to-late-stage PD. The global market dynamics for XADAGO/EQUFINA are shaped by a mix of competitive intensity, regional adoption trends, and payer dynamics. In the U.S. and Europe, the drug has faced stiff competition from generic MAO-B inhibitors (like selegiline and rasagiline) and newer Parkinson's disease therapies, including COMT inhibitors, dopamine agonists, and extended-release levodopa formulations. Despite this, its favorable safety profile and once-daily dosing have supported its uptake in certain patient segments, especially in Europe. Market penetration has been slower in the U.S. due to both reimbursement hurdles and physician preference for more established adjunctive treatments. In Asia, particularly Japan and South Korea, EQUFINA has demonstrated stronger market performance thanks to focused commercial strategies and a high unmet need for effective "off time" management. Meiji Seika Pharma and Eisai, the regional marketing partners, have successfully leveraged the drug's differentiated profile in clinician education, which has led to growing adoption among neurologists. In Japan, where the aging population is rapidly expanding and Parkinson's prevalence is rising, EQUFINA has benefited from both demographic tailwinds and formulary access. Looking ahead, the market outlook for XADAGO/EQUFINA depends on several strategic levers, including lifecycle management, regional partnerships, and real-world evidence generation. The manufacturer's ability to expand into new geographies, secure favorable reimbursement, and differentiate against both generics and newer entrants will be critical. Moreover, as Parkinson's disease treatment moves toward more personalized approaches, XADAGO/EQUFINA may find sustained relevance in specific subpopulations, particularly those requiring a balance of efficacy and tolerability. Dive deeper to get more insight into XADAGO/EQUFINA's strengths & weaknesses relative to competitors @ XADAGO/EQUFINA Market Drug Report Table of Contents Related Reports Parkinson's Disease Market Parkinson's Disease Market Insights, Epidemiology, and Market Forecast – 2034 report deliver an in-depth understanding of the disease, historical and forecasted epidemiology, as well as the market trends, market drivers, market barriers, and key Parkinson's disease companies, including UCB Biopharma SRL, Novartis, Annovis Bio, Supernus Pharmaceuticals, Inc., Britannia Pharmaceutical, Pharma Two B, Mitsubishi Tanabe Pharma (NeuroDerm), AbbVie, Cerevel Therapeutics, Cerevance, among others. Parkinson's Disease Pipeline Parkinson's Disease Pipeline Insight – 2025 report provides comprehensive insights about the pipeline landscape, pipeline drug profiles, including clinical and non-clinical stage products, and the key Parkinson's disease companies, including Cerevel Therapeutics, Inhibikase Therapeutics, Neuraly, Peptron, Biogen, Roche, Brain Neurotherapy Bio, Inc., Modag, Annovis Bio Inc., BioVie Inc., United Neuroscience Ltd., Luye Pharma Group, AbbVie, UCB Biopharma SRL, InnoMedica Schweiz AG, Integrative Research Laboratories AB, H. Lundbeck A/S, Shanghai WD Pharmaceutical Co., Ltd., Cerevance Beta, Inc., Nobilis Therapeutics Inc., BlueRock Therapeutics, Taiwan Mitochondrion Applied Technology Co., Ltd., among others. Cell and Gene Therapy in Parkinson's Disease Market Cell and Gene Therapy in Parkinson's Disease Market Insights, Epidemiology, and Market Forecast – 2034 report deliver an in-depth understanding of the disease, historical and forecasted epidemiology, as well as the market trends, market drivers, market barriers, and key cell and gene therapy in Parkinson's disease companies including MeiraGTx, Hope Biosciences, Sumitomo Pharma, Prevail Therapeutics, BlueRock Therapeutics, Voyager Therapeutics, among others. Parkinson's Disease Psychosis Market Parkinson's Disease Psychosis Market Insights, Epidemiology, and Market Forecast – 2034 report delivers an in-depth understanding of the disease, historical and forecasted epidemiology, as well as the market trends, market drivers, market barriers, and key Parkinson's disease psychosis companies, including Sumitomo Pharma America Inc., Vanda Pharmaceuticals, Acadia Pharmaceuticals Inc., Otsuka America Pharmaceutical, Lundbeck LLC, Jazz Pharmaceuticals, Alkahest Inc., Sandoz, Sio Gene Therapies, Axovant Sciences Ltd, among others. About DelveInsight DelveInsight is a leading Business Consultant and Market Research firm focused exclusively on life sciences. It supports pharma companies by providing comprehensive end-to-end solutions to improve their performance. Get hassle-free access to all the healthcare and pharma market research reports through our subscription-based platform PharmDelve . Contact Us Shruti Thakur [email protected] +14699457679 Logo: SOURCE DelveInsight Business Research, LLP WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

帕金森病（PD）患者在长期使用左旋多巴治疗后，超过80%的患者最终会出现症状波动（如 “关期” 延长、“开期” 缩短、剂末现象等）1。在另一项国内的研究中，接受左旋多巴治疗的中国患者在近1年内有29.0%出现症状波动，而10年以上人群中症状波动的发生率则高达68.3%2。在一项针对帕金森患者的问卷调查中，高达66.3%的患者认为改善症状波动非常重要3。因此，对帕金森患者的症状波动现象进行更好的管理对改善患者的生活质量有很重要的意义。         为了更好地协助医生们针对患者个体选择合适的治疗方案，MDS（International Parkinson and Movement Disorder Society，国际帕金森和运动障碍学会）在2002年第一次基于循证医学证据发表了选择治疗方法的建议，而且之后也在定期更新，最近一次的更新是在2018年。截至目前，针对帕金森病运动症状的治疗方案仍然在不断增加，多项临床试验结果也在陆续发表。因此在2025年，MDS基于102项随机对照试验（RCT，randomized controlled trial），采用了新的评估方法，系统评估了现有治疗手段（包括药物和手术）的有效性与安全性，为临床决策提供了重要参考（图1）4。             图1在文章中，针对每一项干预措施的疗效评价都采用了两个维度：（1）结局的临床相关性（the clinical relevance of the outcome）；（2）证据质量（the quality of the evidence）。为了确定临床结局的相关性，如果有临床数据，就会使用相应量表上的最小临床重要差异（MCID，minimal clinically important differences）。对于 “开期” 时长、“关期” 时长以及无异动症的时间长度，最小临床重要差异为每天1小时5。而对于PDQ-39（帕金森病问卷 - 39 项，Parkinson's Disease Questionnaire - 39），最小临床重要差异为5分6。在证据质量方面，采用改良的GRADE方法（modified version of Grading of Recommendations, Assessment, Development, and Evaluations)，基于偏倚风险、不精确性、不一致性、间接性以及发表偏倚的可能性，对每一项干预措施有效性的证据质量进行评估（图2）。         图2沙非胺（既往称沙芬酰胺，safinamide）是新一代的MAO-B（ B型单胺氧化酶，monoamine oxidase B）抑制剂，并且是所有药物中唯一的具有双重作用机制抗帕金森的药物。沙非胺除了通过抑制MAO-B对多巴胺递质的分解代谢外，还可以通过阻滞离子通道的途径来抑制过量谷氨酸的释放来改善帕金森患者的症状7。该篇文献经过筛查最终纳入了4项与沙非胺相关的RCT8-11。在4项RCT中，对比评估了沙非胺和安慰剂之间对于改善“开期”和“关期”时间的疗效。全部试验都观察到了具有临床意义的“关期”时间减少（相比安慰剂组减少约1h），并且增加了不伴有令人困扰的运动障碍的“开期”时间（相比安慰剂组增加约1h），显示了沙非胺对于症状波动者的优越疗效。在PDQ-39评分表方面，其中1项研究8显示沙非胺达到了改善日常生活质量的阈值，另一项研究9提示在沙非胺100mg组中，对于安慰剂，PDQ-39评分的改善也超过了5分的阈值均提示了其在改善帕金森病患者日常生活质量的作用。           另一方面，值得注意的是MDS目前基于现有研究认为，沙非胺是唯一具有双重作用机制（MAO-B抑制和通道阻滞）的抗帕金森药物。而且在药物有效性方面，相比于前两代MAO-B阻滞剂司来吉兰和雷沙吉兰，其对于症状波动的改善有更高程度的证据支持（沙非胺为有效，司来吉兰为证据不足，雷沙吉兰为可能有效）。并且唑尼沙胺（zonisamide）不再被认为是双机制治疗药物，其对症状波动的有效性方面，MDS也基于最新证据也将其从有效调整为可能有效（图3）。              图3此外，IPX 066, ER（卡比多巴 / 左旋多巴缓释剂，Levodopa Carbidopa Extended – Release，IPX 066为其研究代码）在治疗症状波动上也有令人满意的效果，而且是唯一被MDS认为有效的Levodopa/PDI（左旋多巴 / 外周脱羧酶抑制剂）类药物。文中参考了1篇发表于2013年的RCT12。该研究发现IPX 066相比对照组在减少“关期”时间上有明显优势（约1.2 h ，P < 0.0001），并且在“开期”时间上也有明确改善（不伴令人困扰的运动障碍的“开期”时间为0.9 h, P < 0.001；不伴任何运动障碍的“开期”时间为0.7 h, P < 0.05）（图4）。           图4在外科治疗方面，MDS也对各种治疗方式的临床有效性做了较大的调整。当前，Bilateral STN DBS（Bilateral Subthalamic Nucleus Deep Brain Stimulation，双侧丘脑底核脑深部电刺激术）是唯一被MDS认为有效的术式。而在上一版推荐中同样被认为有效的Bilateral GPi DBS（Bilateral Globus Pallidus Internus Deep Brain Stimulation，双侧苍白球内侧部脑深部电刺激术）和Unilateral pallidotomy（单侧苍白球切开术）现已被调整为可能有效（图5）。               图5时隔7年 MDS 从数据库中15485篇相关文章最终筛选了102项高质量 RCT，并且采用了新的方法来对所有纳入的文章进行治疗有效性分析和证据质量分级。随着时间推移、新药的开发和更多临床试验结果的发表，人们对于帕金森运动波动的理解和治疗观念也随之发生改变：IPX 066成为唯一达到有效级别的 Levodopa/PDI 类药物、普拉克索和罗替高汀的治疗地位仍然稳固、恩他卡朋和雷沙吉兰的有效性级别下降、沙非胺成为唯一有效的双机制药物、唑尼沙胺在有效性级别下降的同时也不再被认为具有通道阻滞的作用、 Bilateral STN DBS是当前证据最充分的针对运动波动症状的手术方案。未来随着更多新药的开发和临床试验的进行，治疗的选择仍然可能会出现变化。            MDS最新的循证医学建议确认了沙非胺对于帕金森病症状波动治疗的有效性。作为新一代的MAO-B抑制剂，沙非胺可以抑制MAO-B对于多巴胺递质的代谢，同时调节钠离子和钙离子通道抑制过量谷氨酸的释放，通过目前唯一的双重抗帕金森机制，可以明显减少“关期”时间并且增加不伴有令人困扰的运动障碍的“开期”时间，其在改善PDQ-39评分方面也有一定的优势，并且对于非运动症状也有明显的改善作用13-15。在帕金森病的治疗中，尤其是出现运动并发症的患者，沙非胺将会是很有优势的选择。              参考文献1. Stocchi F, Antonini A, Barone P,et al. Early DEtection of wEaring off in Parkinson disease: the DEEP study. Parkinsonism Relat Disord. 2014 Feb;20(2):204-11. 2. Wan Y, Yuan C. Hou X, et al. Wearing-off Identification in Parkinson's Disease: The shapd-woq Study. Front Neurol. 2020 Mar 13:11:116.3. Wüllner U, Fuchs G, Reketat N, et al. Requirements for Parkinson's disease pharmacotherapy from the patients' perspective: a questionnaire-based survey. Curr Med Res Opin. 2012 Jul;28(7):1239-46. study. Parkinsonism Relat Disord. 2014 Feb;20(2):204-11. 4. de Bie RMA, Katzenschlager R, Swinnen BEKS, Peball M, Lim SY, Mestre TA, Perez Lloret S, Coelho M, Aquino C, Tan AH, Bruno V, Dijk JM, Heim B, Lin CH, Kauppila LA, Litvan I, Spijker R, Seppi K, Costa J, Sampaio C, Fox SH, Silverdale MA. Update on Treatments for Parkinson's Disease Motor Fluctuations - An International Parkinson and Movement Disorder Society Evidence-Based Medicine Review. Mov Disord. 2025 Mar 8. doi: 10.1002/mds.30162. Epub ahead of print. PMID: 40055961. 5. Hauser RA, Gordon MF, Mizuno Y, et al. Minimal clinically important difference in Parkinson’s disease as assessed in pivotal trials of pramipexole extended release. Parkinsons Dis 2014;2014: 467131. 6. Horvath K, Aschermann Z, Kovacs M, et al. Changes in quality of life in Parkinson’s disease: how large must they be to be relevant Neuroepidemiology 2017;48(1–2):1–8. 7. Calabresi p, Kulisevsky J. Safinamide as Add-on Therapy - Moving Beyond Dopamine for a Multifaceted Approach in Parkinson's Disease.European Neurological Review,2017:12(Suppl. 5):2-6.  8. Borgohain R, Szasz J, Stanzione P, et al. Randomized trial of safinamide add-on to levodopa in Parkinson’s disease with motor fluctuations. Mov Disord 2014;29(2):229–237.  9. Hattori N, Tsuboi Y, Yamamoto A, Sasagawa Y, Nomoto M. Efficacy and safety of safinamide as an add-on therapy to L-DOPA for patients with Parkinson’s disease: a randomized, double-blind, placebo- controlled, phase II/III study. Parkinsonism Relat Disord 2020;75:17–23.  10. Schapira AHV, Fox SH, Hauser RA, et al. Assessment of safety and efficacy of safinamide as a levodopa adjunct in patients with Parkinson disease and motor fluctuations: a randomized clinical trial. JAMA Neurol 2017;74(2):216–224. 11. Wei Q, Tan Y, Xu P, et al. The XINDI study: a randomized phase III clinical trial evaluating the efficacy and safety of safinamide as add-on therapy to levodopa in Chinese patients with Parkinson’s disease with motor fluctuations. CNS Drugs 2022;36:1217–1227.  12. Hauser RA, Hsu A, Kell S, et al. Extended-release carbidopa-levodopa (IPX066) compared with immediate-release carbidopa-levodopa in patients with Parkinson’s disease and motor fluctuations: a phase 3 randomised, double-blind trial. Lancet Neurol 2013;12(4): 346–356. 13. Cattaneo C, M¨uller T, Bonizzoni E, et al. Long-Term Effects of Safinamide on Mood Fluctuations in Parkinson's Disease. J Parkinsons Dis. 2017;7(4):629-634. 14. Cattaneo C, Barone P, Bonizzoni E, et al. Effects of Safinamide on Pain in Fluctuating Parkinson's Disease Patients: A Post-Hoc Analysis. J Parkinsons Dis. 2017;7(1):95-101.   15. García DS, López IC, Guerra CL,et al. Safinamide improves sleep and daytime sleepiness in Parkinson's disease: results from the SAFINONMOTOR study. Neurol Sci. 2022 Apr;43(4):2537-2544. 提示：本材料仅供医疗卫生专业人士进行医学科学交流，不用于推广目的。