Hi all, If this drug sounds too good to be true, I have some anecdotal experience you might consider. I was a part of the study until last week; I had a placebo (worked great!) for the first phase, and then the real drug after the first six months. It may have slowed progression -- I didn't start Sinemet until nine years after diagnosis. A few years ago however we got notice that melanoma had been found in some trial participants. Although an epidemiologist and a dermatologist rated the likelihood of a connection as slim, the FDA required skin exams every three months. Good thing -- last month with no family history of melanoma or excessive sun (in fact I avoided tanning at all), a biopsy revealed melanoma (which is why I am no longer in the study). This is anecdotal, to be sure, but I wonder if the benefits of this drug are sufficient to out weigh even a tiny increased risk of cancer. It will be interesting to be sure to see how this issue is 'packaged' in disclosures for drug marketing. We are accustomed to a world where everything seems like a potential cause of cancer, and I rated the danger in this instance as slight (and rasagaline may not be the cause, but no one can say definitely). But I will say one's perspective changes when a diagnosis is positive. cb ----- Original Message ----- From: "Murray Charters" <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, April 26, 2004 12:34 PM Subject: PRESS RELEASE: Early Treatment With Rasagiline May Slow Parkinson's Disease Impairment > PRESS RELEASE: Early Treatment With Rasagiline May Slow Parkinson's Disease Impairment > Results of 12-month study suggest benefits of early initiation of treatment. > > KANSAS CITY, Mo. and TEANECK, N.J., Apr 20, 2004 /PRNewswire-FirstCall via Comtex/ -- Early initiation of a potential > new treatment for Parkinson's disease may delay the progression of impairment associated with the disease, according to > an article published in the April 2004 issue of Archives of Neurology. In the TEMPO trial, patients treated with once- > daily rasagiline 1 or 2 mg per day for 12 months showed less impairment in Parkinson's disease features than patients > whose treatment was delayed for six months. > > Impairment was measured by total Unified Parkinson's Disease Rating Scale (UPDRS) score, a research tool commonly used > to measure a patient's ability to perform mental and motor tasks and activities of daily life. > > The double-blind study involved 371 patients who were randomized into three treatment groups: rasagiline 2 mg per day > for 12 months, rasagiline 1 mg per day for 12 months, or delayed treatment - placebo for six months followed by > treatment with rasagiline 2 mg per day for six months. The randomized, delayed-start design was intended to help > distinguish immediate symptomatic benefits from effects on disease progression. > > "The difference in UPDRS scores between the 12-month and delayed start rasagiline groups cannot wholly be explained by > rasagiline's symptomatic effect," said Andrew Siderowf, M.D., Assistant Professor of Neurology, University of > Pennsylvania and a lead researcher on the study. > > Results showed treatment with rasagiline 2 mg per day for 12 months was associated with less decline as measured by the > UPDRS scores, demonstrated by a 2.29 unit smaller decline in the mean adjusted total UPDRS scores compared with > patients in the delayed-start group (p=0.013). The difference in the change from baseline for patients treated with 1 > mg per day rasagiline for a full year, compared with the delayed-start group, was 1.82 units (p=0.051). > > An analysis of the activities of daily living subscale of the UPDRS also demonstrated an effect in favor of the group > treated with 2 mg rasagiline for a full year, with the decline being 0.96 units less than the delayed-start group > (p=0.0053). > > "A possible explanation for these results is that rasagiline may slow the progression of Parkinson's disease, but > longer duration studies are needed to confirm these findings," said Ira Shoulson, M.D., Professor of Neurology at the > University of Rochester School of Medicine and principal investigator of the TEMPO study. "This prospect, combined with > our previous findings of benefit and safety (A Controlled Trial of Rasagiline in Early Parkinson's Disease: The TEMPO > Study, Arch Neurol 2002;59:1937-1943) suggests that rasagiline has the potential to be a promising new treatment for > PD." > > The initial 26-week phase of the TEMPO trial (TVP-1012) in the Early Monotherapy in Parkinson's disease Out-patients) > showed that patients who received rasagiline 1 or 2 mg once-daily had better symptom control than those receiving > placebo. The entire 12-month study was conducted by the PSG at 32 sites in the United States and Canada. > > Rasagiline was well tolerated in the study. The most commonly observed adverse events in the active treatment phase > (occurring in more than five percent of patients) were infection, headache, dizziness, and accidental injury. None of > these adverse events occurred significantly more frequently in patients originally assigned to rasagiline than in those > originally assigned to placebo. > > Rasagiline is a novel, potent, second-generation, selective, irreversible monoamine oxidase type-B (MAO-B) inhibitor > that blocks the breakdown of dopamine, a substance in the brain needed to facilitate movement. A new drug application > for rasagiline for the treatment of Parkinson's disease was submitted to the U.S. Food and Drug Administration (FDA) > Sept. 5, 2003. Indications are being sought for once-daily rasagiline as a monotherapy in early Parkinson's disease and > as an adjunct to levodopa in moderate to advanced disease. > > "We are excited about the possibility of marketing a treatment for Parkinson's disease that offers the ease of once- > daily dosing and is well tolerated," said Larry Downey, president of Teva Neuroscience. "The TEMPO 12-month data > suggest the potential of rasagiline to slow PD-related impairment, and we are encouraged by these findings." > > Parkinson's disease is a degenerative disorder of the central nervous system. Symptoms can include tremors, stiffness, > slowness of movement, and impaired balance. An estimated one million North Americans have the disease, which usually > affects people over the age of 50. > > The PSG (www.Parkinson-Study-Group.org) is an independent, non-profit consortium of Parkinson's disease investigators > from medical centers in the United States and Canada who are committed to improving treatment for persons affected by > Parkinson's disease. > > The development of rasagiline is part of a long-term alliance for co-development in Parkinson's disease and European > marketing between Teva and H. Lundbeck A/S. Rasagiline was developed cooperatively by Teva and the Technion - Israel > Institute of Technology. > > Teva submitted an application to market rasagiline as a treatment for PD with the European Agency for Evaluation of > Medicinal Products (EMEA) on Oct. 10, 2003. Rasagiline was also submitted for review in Canada Sept. 24, 2003 where, > upon approval, it will be marketed by Teva Neuroscience, Inc. > > Teva Neuroscience, Inc. and Eisai Inc. will co-promote rasagiline in the United States, once approved by the FDA, as > part of a long-term strategic alliance between Teva Pharmaceutical Industries Ltd. and Eisai Co., Ltd. > > Teva Pharmaceutical Industries Ltd. (Nasdaq: TEVA), headquartered in Israel, is among the top 30 pharmaceutical > companies in the world. The company develops, manufactures, and markets generic and branded human pharmaceuticals and > active pharmaceutical ingredients. Close to 90 percent of Teva's sales are in North America and Europe. Teva's > innovative R&D focuses on developing novel drugs for diseases of the central nervous system. > > Eisai Inc. is a U.S. pharmaceutical subsidiary of Eisai Co., Ltd., a research-based human health care (hhc) company > that discovers, develops, and markets products in more than 30 countries. Established in 1995, Eisai Inc. began > marketing its first product in the United States in 1997 and has rapidly grown to become an integrated pharmaceutical > business with sales of nearly $1.5 billion in fiscal year 2002 (year ending March 31, 2003). Eisai focuses its efforts > in four therapeutic areas: neurology, gastrointestinal disorders, oncology, and acute care. > > Safe Harbor Statement under the U.S. Private Securities Litigation Reform Act of 1995: This release contains forward- > looking statements, which express the current beliefs and expectations of management. Such statements are based on > current expectations and involve a number of known and unknown risks and uncertainties that could cause Teva's and > Eisai's future results, performance or achievements to differ significantly from the results, performance or > achievements expressed or implied by such forward-looking statements. Important factors that could cause or contribute > to such differences include Teva's and Eisai's ability to successfully develop and commercialize additional > pharmaceutical products, the introduction of competitive generic products, the impact of competition from brand-name > companies that sell their own generic products or successfully extend the exclusivity period of their branded products, > Teva's and Eisai's ability to rapidly integrate the operations of acquired businesses, the availability of product > liability coverage in the current insurance market, the impact of pharmaceutical industry regulation and pending > legislation that could affect the pharmaceutical industry, the difficulty of predicting U.S. Food and Drug > Administration ("FDA") and other regulatory authority approvals, the regulatory environment and changes in the health > policies and structure of various countries, acceptance and demand for new pharmaceutical products and new therapies, > uncertainties regarding market acceptance of innovative products newly launched, currently being sold or in > development, the impact of restructuring of clients, reliance on strategic alliances, exposure to product liability > claims, dependence on patent and other protections for innovative products, fluctuations in currency, exchange and > interest rates, operating results and other factors that are discussed in Teva's Annual Report on Form 20-F and its > other filings with the U.S. Securities and Exchange Commission ("SEC"). Forward-looking statements speak only as of the > date on which they are made, and the Company undertakes no obligation to update publicly or revise any forward-looking > statement, whether as a result of new information, future developments or otherwise. > > SOURCE Teva Neuroscience, Inc. > > CONTACT: > > Marie Jennings of Fleishman-Hillard, > +1-816-512-2430, > [log in to unmask] > > Judee Shuler of Eisai Inc., > +1-201-287-2241 > [log in to unmask] > > URL: > > http://www.prnewswire.com > > SOURCE: PR Newswire / Macro*World Investor > http://www.mworld.com/m/m.w?lp=GetStory&id=92046201 > > * * * > > ARTICLE: Early Treatment with Rasagiline Better than 6-Month Delay in Parkinson's Disease, Results in Less Functional > Decline > > A DGReview of :"A controlled, randomized, delayed-start study of rasagiline in early Parkinson disease" > Archives of Neurology > > 04/20/2004 > By Elda Hauschildt > > Patients with early Parkinson's disease who are treated with rasagiline show less functional decline at 12 months than > do those patients whose treatment is delayed for 6 months, say researchers. > > Andrew Siderowf, MD, of the Parkinson's Disease and Movement Disorders Center, University of Philadelphia, > Pennsylvania, United States, and colleagues undertook a double-blind, parallel-group, delayed start clinical trial in > order to compare the effects of immediate versus delayed treatment with rasagiline in patients with early Parkinson's > disease. > > A total of 404 patients were enrolled at 32 sites in the United States and Canada between November 1997 and June 1999. > Participants were older than 35 years and had been confirmed with idiopathic Parkinson's disease. > > The patients were randomised to receive rasagiline, 1 mg/day for 1 year, 2 mg/day for 1 year, or matching placebo for 6 > months, followed by rasagiline, 2 mg daily, for 6 more months. > > The researchers found that the patients who were treated with 2 mg/day of rasagiline had a 2.29-unit smaller increase > in mean, adjusted total UPDRS score compared with those who received placebo for 6 months before rasagiline (P = .05). > > Examinations took place at baseline and at 4, 8, 14, 20, 26, 32, 42 and 52 weeks after randomisation. The assessments > included mental, activities of daily living and motor subscales of the Unified Parkinson's Disease Rating Scale (UPDRS) > as well as other scales for activities of daily living. > > The 1-year efficacy analysis included the 371 patients who took part in the active treatment phase. There were no > significant differences in baseline characteristics of these participants. > > Of the patients receiving 2 mg of rasagiline for the full 12 months, 63.8% were considered responders as were 52.5% of > those who received 1 mg. Of the delayed treatment group, 52.3% were responders. The difference between the delayed > group and the 1 mg group was not considered significant (P = .93). > > Rasagiline mesylate, an irreversible monoamine oxidase type B inhibitor, has been shown to improve symptoms of early > Parkinson's, Dr. Siderowf notes. An earlier 6-month placebo-controlled phase of the study had demonstrated better > symptom control among patients taking rasagiline over those taking placebo. In this study, a randomised, delayed-start > design was used to separate an immediate, symptomatic effect from an effect on disease progression. > > "Because all subjects were receiving rasagiline in the second phase, the symptomatic effects of the drug were > presumably balanced at the last examination," the researchers explain. Differences observed in performance, therefore, > could not be explained by the symptomatic effects of the drug. > > Archives of Neurology 2004;61:561-566. "A controlled, randomized, delayed-start study of rasagiline in early Parkinson > disease" > > SOURCE: Doctor's Guide > http://tinyurl.com/26ly7 > > * * * > > Rasagiline May Slow PD Decline > > April 20, 2004 > > A controlled, randomized delayed-start study of rasagiline in early Parkinson disease > Parkinson Study Group > Arch Neurol 2004; 61:561-566 > > The MAO-B inhibitor rasagiline may delay progression of Parkinson's disease, according to this study. > > Four hundred and four patients with early PD not receiving dopaminergic treatment were randomized to one of three > groups: (1) rasagiline 1 mg/day; (2) rasagiline 2 mg/day; or (3) placebo followed at 6 months by commencement of > rasagiline at 2 mg/day; with the double blind preserved until one year. A report on the six-month interim analysis is > archived at http://www.mdvu.org/emove/article.asp?ID=370 > > According to the authors, "The randomized delayed-start design used in this study was intended to separate an immediate > symptomatic effect from an effect on disease progression..Because all subjects were receiving rasagiline in the second > phase of the study, the symptomatic effects of the drug were presumably balanced in the last examination." > > Of the 404 patients, 33 withdrew or began dopaminergic treatment before the first assessment in the second six months > of the trial, leaving 371 patients in the intent-to-treat group for efficacy analysis. > > A beneficial effect of early vs. delayed rasagiline was seen on total UPDRS and UPDRS activities of daily living, but > not motor scores. After 12 months, compared to Group 3, total UPDRS for Group 1 was better by 1.82 points (p=0.05), and > for Group 2 was better by 2.29 points (p=0.01). The ADL score was 0.96 points better for Group 2 versus Group 1 > (p=0.005), but not significantly better for Group 1 versus Group 3. Adverse effects were similar among all groups. > > The authors conclude, "Subjects treated with rasagiline, 2 and 1 mg/day, for 12 months showed less functional decline > than subjects whose treatment was delayed for 6 months." The differences "cannot be fully explained by [rasagiline's] > symptomatic effect and may be due to a disease-modifying activity of the drug." > > Supported by Teva Pharmaceuticals > > SOURCE: We Move > http://tinyurl.com/3g6sg > > * * * > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn