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La rasagiline ( Argilect) diminue les temps ´off´ des PCP traites par 
dopatherapie.

Maryse

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The source of this article is rxpgnews.com: http://tinyurl.com/6ftya

Parkinson's
Rasagiline Significantly Reduces 'OFF' Time in Parkinson's - Study shows
By Akanksha,Pharmacology Correspondent
Feb 15, 2005, 08:15

Patients with moderate-to-advanced Parkinson's disease (PD) experiencing
motor complications who added once-daily AGILECT(R) (rasagiline tablets) to
their treatment with optimized levodopa with or without stable doses of
other anti-PD medications experienced a significant improvement in their PD
symptoms and a significant reduction in "off" time according to the "PRESTO"
study published in the February issue of Archives of Neurology.Rasagiline
was dosed once-daily and required no titration.

"Results from this study show benefits of rasagiline compared with placebo
in moderate-to-advanced levodopa-treated PD patients experiencing motor
complications. During disease progression and after months or years of
levodopa therapy, these patients commonly experience motor complications,
such as unpredictable fluctuations between 'on' and 'off' time," said Ira
Shoulson,M.D., professor of neurology at the University of Rochester School
of Medicine and principal investigator of the Parkinson Study Group
(PSG),the organization that conducted the "PRESTO" trial. "This study showed
that rasagiline demonstrated significant benefit in reducing 'off' time,
increasing 'on' time, and improving features of Parkinson's disease."

The multicenter, randomized, placebo-controlled, double-blind, parallel
group "Parkinson's Rasagiline: Efficacy and Safety in the Treatment of
'Off'" (PRESTO) study included 472 PD patients who were experiencing at
least 2.5 hours of daily "off" time despite optimized treatment with
levodopa with or without stable doses of other anti-PD medications at 57 PSG
sites in the United States and Canada.

Many patients enrolled were treated, in addition to levodopa, with
dopamine agonists, entacapone and/or anticholinergic medications.  Patients
received 1 mg or 0.5 mg Rasagiline tablets or placebo once daily.The average
reduction in "off" time among patients using Rasagiline was 1.85 hours daily
for the 1 mg group and 1.41 hours daily in the 0.5 mg group,while placebo
provided a reduction of 0.91 hours daily.

Additionally, rasagiline significantly improved motor function during
"on"time (time when medication effectively manages symptoms of PD) and
activities of daily living during "off" state based on the Unified
Parkinson's Disease Rating Scale (UPDRS). The UPDRS is a research tool
commonly used to measure a PD patient's ability to perform motor and mental
tasks and activities of daily life.Rasagiline also showed significant
improvement on Clinical Global Improvement (CGI) scale scores rated by the
examiner. Quality of life,as measured by the PD -- Quality of Life
(PDQUALIF) scale, showed a trend toward improvement in patients treated with
rasagiline 0.5 mg/day, but not with rasagiline 1 mg/day.

"Rasagiline decreased 'off' time and increased the amount of 'on' time,"
said Matt Stern, M.D., professor of neurology at the University of
Pennsylvania and co-principal investigator for the PRESTO study. "The
efficacy and tolerability of rasagiline, as demonstrated in this trial,
combined with its once-daily dosing, suggest it may be a promising new
treatment for PD."

Patients on rasagiline experienced side effects similar to those of
patients on placebo.Adverse events significantly more common with rasagiline
than with placebo were balance difficulty in the 0.5 mg rasagiline group,
and weight loss, vomiting, and anorexia in the 1 mg rasagiline group.

Balance difficulty occurred slightly more often in the rasagiline treated
patients, but did not appear to be dose-related.Dyskinesias were reported as
an adverse event in 10 percent of patients receiving placebo and 18 percent
of patients receiving either dosage of rasagiline but did not lead to early
terminations.

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 PD 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 PD and as an
adjunct to levodopa in moderate-to-advanced disease.

Parkinson's disease is a degenerative disorder of the brain. Symptoms can
include tremor, stiffness, slowness of movement and impaired balance. An
estimated one million North Americans have PD, which usually affects people
over the age of 50.

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 and H. Lundbeck A/S will co-promote the product in Europe, upon
expected receipt of Marketing Authorization in Q1 2005.

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