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Dear Terry, Dee, and Parkinsn List: Mirapex is a very good drug. There are many PWP (like Terry and others) who have benefited from it, in the same way that there are many who have benefited from Permax, Requip and Levodopa. Its efficacy as an anti-Parkinson drug is very clear. My objection is not to the drug. My objection is to the publicity and spin that has been given to the recent findings that are at best preliminary, trying to paint Mirapex as a proven neuroprotective agent. That is a marketing ploy. Yes, the drug companies will inflate the claims of efficacy of their drugs, just like Chevrolet will tell you their trucks are better than GMC. The JAMA article is available for anyone to read. Some aspects of it are very technical. The investigators were very careful and honest in how they worded their conclusions. I quote directly from the article: "These imaging data highlight the need to further compare imaging and clinical endpoints of PD progression in long-term studies." "These data highlight the need to compare this imaging marker of dopamine neuronal loss with multiple meaningful clinical endpoints of disease progression in larger, long term studies to fully assess its clinical relevance." How is it that the press and the media have transformed this into a claim for neuroprotection? Dolores points out that her own reading of the report sounds less than conclusive. That is the point. It isn't conclusive. In fact, some of its data is outright puzzling since they were unable to correlate the radioisotope findings with clinical measures of disease progression which they themselves chose before the study. The study was well-done and planned. Drug companies will sell you drugs the same way GM, FORD and Chrysler sell you cars. They will do everything they can to convince you that their drug is the best. They do so with doctors too. Many doctors will rely on drug company provided information for their education on new drugs, because going to the primary literature is very time consuming. To assume that drug companies sell drugs for the benefit of patients, would be like stating that the car manufacturers sell cars to provide for public transportation. They are both selling a product to make a profit. They don't have lofty humanitarian motives - they are corporations with responsibility to shareholders, who also invest in drug company stock to make a profit - not to support the delivery of healthcare. Proving the legitimacy of some claims concerning drugs takes time and intensive research. The history of Eldepryl (selegiline) in PD is an example. The initial DATATOP study suggested that selegiline might delay the progression of PD. Theoretical and animal models seemed to support such claims. Later, longer term follow-up studies disproved that claim in humans. But, even to this date, there is some interest in reviving the alleged neuroprotective effect of selegiline. Yet, when the initial studies seemed to point in that direction, the drug company pushed the drug as hard as they could - and almost every PWP ended up taking selegiline for a few years. And Somerset and Sandoz took the profits to the bank with a smile. The market for antiParkinson drugs is fierce. There are claims, and counterclaims of better efficacy, fewer side effects, and the most recent words are "avoiding toxicity" and "neuroprotection." The dopamine agonist companies would like to "dethrone" levodopa as the gold standard for initial treatment. They are ganging up 3 to 1 against levodopa, but they are also competing with each other. All I urge is caution: careful analysis of claims. When there is controversy, listen carefully to both sides. When there is a new claim that sounds too good to be true...it probably is. Every new finding in research, however, even if done with drug company sponsorship, is capable of contributing a brick to this castle. That is how progress is made in science - brick by brick. I still have my eyes open hoping to find a piece of real-estate in Florida where I will find the Fountain of Youth. Jorge Romero, MD ----- Original Message ----- From: "Terry Bowers" <[log in to unmask]> To: <[log in to unmask]> Sent: Sunday, April 07, 2002 10:55 AM Subject: Re: Tremor and PD > Dear List, > > And as far as Mirapex goes, I thank God for the researchers who worked the > problem, Pharmacia and their shareholders who foot the bill, the doctor who > prescribes the Mirapex and the pharmacists who fills the prescription. I > would gladly pay twice the price of one hundred and sixty dollars every > month for the relief and benefit I receive. > > Sincerely, > > Terry Bowers > ----- Original Message ----- > From: "Dolores Buente" <[log in to unmask]> > To: <[log in to unmask]> > Sent: Sunday, April 07, 2002 7:50 AM > Subject: Tremor and PD > > > > Dear Jorge, > > After reading your post in regard to mirapex and it's effectiveness or > > (ineffectiveness) in neuroprotection, I am prompted to respond. It seems > > that the report of the studies done in this area have been highly promoted > > and would lead to a general acceptance of the effectiveness of this drug > > (mirapex) as a neuroprotectant. Of course, with this perception, the > sales > > of this drug will undoubtedly increase dramatically. > > Since this study was carried out by the drug company which manufactures > and > > sells the drug in question, it leads to doubts as to it's unbiased > > conclusions. I have read the published report on the study and the > wording > > sounds vague and less than conclusive. I feel that it would be a > travesty, > > if in fact it could be true, that the drug companies who are selling drugs > to > > those who are so desperate for the glimmer of a hope could stoop to the > level > > of promising something that is less than authentic. > > I take Requip now and am doing so because I was told that it will treat > my > > symptoms and enable me to delay taking leva-dopa. I made this decision > based > > upon my doctor's recommendation, my reliance on his informed medical > opinion > > and the belief in his genuine concern for me that he would advise the best > > treatment possible for my disorder. To think that drug companies would > > perform otherwise just to boost their sales to become even richer is not > > acceptable. Now the question is: how is the legitimacy of this finding > > proved or disproved. > > Dee ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn