I dont know whom to believe !
Imad



THE EFFECT OF RASAGILINE ON PARKINSON'S DISEASE

New England Journal of Medicine [2009] 361 (13) : 1268-1278 (Olanow CW, et al) Complete abstract

Claims based on the results of a recent clinical trial that Rasagiline (Azilect) slows the progression of Parkinson's Disease are not supported at all by that study's results. Yet it has still been very widely, and falsely claimed that Rasagiline slows the progression of Parkinson's Disease. Rasagiline is a MAO inhibitor, which is a type of drug that is often used in Parkinson's Disease alone, or alongside other treatments. For more information go to Rasagiline. The clinical trial involved over a thousand patients. In early-start treatment with Rasagiline at a dose of 1 mg per day, there was actually a worsening of Parkinson's Disease symptoms throughout the clinical trial. As time progressed during the clinical trial, the effect of 1mg of 1mg Rasagiline was found to be no different from those people that had taken Rasagiline for only half of the time. The use of 2mg Rasagiline per day was also shown to be no better than the use of 1mg or delaying the use of Rasagiline. For more current news go to Parkinson's Disease News.

Imad,

Thank you for sharing this research finding. Many people are helped by Rasagiline, but I could not tolerate the side effects. I also felt worse over all when on it.

It's interesting that so many myths seem to exist over treatments and a lot of the misinformation seems to start at the doctor's office

If you look closely at the latest Azilect study- they claim it's neuroprotective despite unclea, contradictory results and the lea researcher has direct ties to Teva, the pharma that happens to make the drug. It's hard not to see this as flawed.

Laura

i remember attending a lecture about selegiline during the WPC in Wash DC several yrs ago--Olanow was the "princiipal investigator" presenting all the newest information about selegiline, and i wondered at the time why this info was included when rasagiline was the "newest kid on the block". I had the impression that these newer studies on selegiline were to give the drug a regenesis. I actually wrote a scathing assessment of the lecture and its content (will this statement disqualify me for attendance at future WPC's?)since i thought it was very old information, dressed up (i think a comparison btn selegiline and vit E was part of the presentation) to counter any new info to be presented about rasagiline. I questioned the $$ and time spent trying to give an old drug a new life just because it had competition from a new formulation. I now wonder if olanow has an ax to grind, given his reputation/funding/lab work is/has been greatly concerned with selegiline? Perhaps he really believes selegiline is better. (it does help to have faith in one's own product)
The primary reason my husband chose rasagiline over selegiline was the fact one of the major metabolites in selegiline's breakdown is an amphetamine-like substance. Rasagiline (azilect) does not breakdown into this substance. Though I have read that some neurologists utilize selegiline specifically because of its amphetamine metabolite, to combat fatigue. Were we correct in choosing rasagiline over selegiline? No way of knowing since there was/is no control. otherwise, he is one of the newest guinea pigs for rasagaline. and who knows, perhaps it will be proven neuroprotective. I just know everything on the planet except blue lights is contraindicated when one is taking an MAO inhibitor (i really do not know about blue lights--have not researched that yet)

Props to you for having the chutzpah to criticize at the WPC! Who did you write the assessment for or to? Did you get a response?

This really exemplifies what is largely wrong with our treatment options. Not only do we have severely limited choice due to issues with the placebo model, but the choices we do have seem to be engineered largely by pacts between practitioners and pharma. Why is it every time I visit the neuro, she is pushing the latest snake oil? It's always Mirapex first over Requip, or Rasagiline over Selegiline....

Thereis an alternative to the pharma brand of Selegiline- it's liquid deprenyl or liquid selegiline citrate, it's plant derived, so natural; only I can't find a reliable source for it. The liquid form is more pure in that it does not metabolize into meth. This is a "bonus" that the synthetic version provides.

Interestingly, there is a conspiracy theory circulating around on the Internet that the developer of liquid deprenyl, James Kimball, was railroaded by the FDA and ended up in jail...not sure how true this is all is though nothing surprises me anymore, sadly.

Laura

you have unintentionally made it seem like this piece, critical of the rasagiline trial results, was a research study from the New England Journal of Medicine.

In fact, the ORIGINAL STUDY is what was published in the New England Journal of Medicine. Olanow et al published the actual study in the NEJM and from what I've read Olanow is cautiously excited about the results of the study.

http://www.pharmatimes.com/ClinicalN....aspx?id=16640

"The finding that early treatment with rasagiline 1mg per day provides benefits that cannot be achieved with later administration of the same drug indicates that these benefits are not simply due to a symptomatic effect of the drug and are consistent with the possibility that the drug is disease-modifying,” Dr Olanow commented.

“If this can be confirmed, this would be the first drug determined to have a disease-modifying effect in PD, and that is exciting news for the PD community.”

Your piece in the original post is NOT written by Olanow and was NOT published in the New England Journal of Medicine.

I don't know who wrote it, because I can't get the link to work, but it sounds like someone disgruntled and with an axe to grind.

Cal

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I hate to rain on the media parade about this, but we began taking azilect as soon as it became available here in the US. We have not only progressed, but have progressed much faster than expected. We have taken Azilect faithfully, daily, for years now.

We continue to be amazed at how liberal our press is in making statements like the ones plastered all over the internet about this med. Some articles don't even hedge things, they come right out and say Azilect IS neuroprotective and slows progression-ha! And these oh-so-favorable press releases only run the stock price of the manufacturer higher and higher...

Our neuro was skeptical when Azilect came out because the exact same thing happened when Mirapex came out. It was heralded as "the" thing, disease-modifying...alas, ten plus years later, they had to admit it had no such effect. But in the meantime, a lot of folks made a lot of money off their stock in the company. Hate to be cynical, just have first-hand experience with this med, from the get-go.

I may be wrong, but I think this "critique" comes from the self-described PD expert at ******* (never could figure out what this person's qualifications are). I think the person who runs this web site used to post here under several different names.

http://************/parkinsons.disease/news.htm

I did not interpret Imad's criticism as coming from the NEJM- I saw the post as two separate parts: the link to the actual article (thought it was just broken link) and the criticism which I thought was written by Imad. I just realized that the link is broken because it was copy/pasted and not added as HTML link through the forum editor. To further confuse...

Hope this helps.

Laura

Interestingly, this link, although it appears correct when editing, posts as this and the link is broken. I suspect that this is code an intentional block either by the forum administration or by the person who runs the site. This person has been banned from Wikipedia and other sites for vandalizing; I think he was known in these parts as Daffy Duck. From what I understand, he tries to use multiple IPS addresses to gain entry into sites that ban him.

Anyway, as a work around, if you're curious google v i a r t i s and go to the news page.

I apologise for publishing what seems to be a deceptive research.
if you google "The effect of rasagiline on parkinson's disease " you will come by the article (second link) . I realize now it is a misinterpretation of the original article ( http://www.ncbi.nlm.nih.gov/pubmed/19776408 )
(A double-blind, delayed-start trial of rasagiline in Parkinson's disease.)
so sorry. realize now how important to check material before publishing.
Imad