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Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. We report here an exploratory analysis assessing whether prasinezumab showed greater benefits on motor signs progression in prespecified subgroups with faster motor progression.
In these subpopulations, the effect of prasinezumab on slowing motor signs progression MDS-UPDRS Part III was greater in the rapidly progressing subpopulations for example, participants who were diffuse malignant or taking monoamine oxidase B inhibitors at baseline. However, because this was a post hoc analysis, additional randomized clinical trials are needed to validate these findings. Except for the use of MAO-B inhibitors, other symptomatic medications for PD, including levodopa and dopamine agonists, were not allowed at baseline, and their use was discouraged for the duration of the double-blind period of the study, unless absolutely necessary.
In those cases, a prior-to-start of symptomatic treatment visit was performed to collect MDS-UPDRS 5 scores before symptomatic medication was commenced. Although the PASADENA MDS-UPDRS findings should be considered preliminary because there was no provision for correcting confidence interval CI widths for multiple comparisons, they are consistent with the idea that a potential treatment effect on disease progression can only be demonstrated when patients progress sufficiently on the endpoint of interest.
We therefore hypothesized that prasinezumab might show a greater effect in subpopulations with rapidly progressing disease, as measured by MDS-UPDRS Part III, compared with more slowly progressing subpopulations, because greater progression with comparable variability of progression is expected to increase the signal-to-noise ratio degree of change over time and the likelihood of revealing a potential treatment effect The initial PASADENA protocol 10 included six prespecified primary subpopulations and nine prespecified exploratory subpopulations, defined by factors known to be associated with faster progression, such as MAO-B inhibitors at baseline versus treatment-naive , Hoehn and Yahr stage 2 versus stage 1 and diffuse malignant phenotypes versus nondiffuse malignant phenotypes Table 1.