International Movement Disorder Specialists Receive New Information About The Use Of Once-Daily AZILECT(R) In The Treatment Of Parkinson's Disease

09 Jun 2007
http://www.pharma-lexicon.com/medica...p?newsid=73658

New information on the use of AZILECT(R) (rasagiline tablets) for the treatment of Parkinson's disease (PD) was reported this week at The Movement Disorder Society's congress in Istanbul, Turkey. Once-daily AZILECT was approved by the FDA May 17, 2006, for the treatment of the signs and symptoms of PD, both as initial monotherapy and as adjunct therapy to levodopa.

AZILECT(R) Monotherapy Demonstrates Benefits in Early PD Regardless of Disease Duration

Dr. John Bertoni, M.D., Ph.D., Creighton University provided the results of a new post-hoc analysis of the 26-week, multicenter, randomized, double-blind TEMPO study, that included 404 patients who received once-daily AZILECT 1mg, 2mg, or placebo. This analysis revealed that AZILECT once-daily as monotherapy provided a consistent beneficial effect on the symptoms of PD regardless of the duration of the disease at the time treatment was started. AZILECT 1 mg/day significantly improved UPDRS-Total score compared to placebo in both the < 1-year stratum (-0.52 vs 3.33; p<0.001) and the greater than or equal to 1-year stratum (0.81 vs 4.76; p<0.01). "The time to diagnosis and initial treatment is different for every patient," said Dr. Bertoni. "Demonstrating that AZILECT monotherapy has a beneficial effect, regardless of disease duration, is important when considering it as a treatment option for patients with PD."

AZILECT(R) Clinical Experience When Given Concomitantly with Antidepressants

Dr. Michel Panisset, M.D., CHUM - Hotel-Dieu de Montreal, Quebec, reported on an evaluation of the records of 1,361 patients who had taken AZILECT for the treatment of Parkinson's disease in controlled clinical trials to assess the safety of combining antidepressant therapy with AZILECT. Three hundred and twenty three (323) of the total 1,361 patients (24%) were noted to have taken a concomitant antidepressant, including amitriptyline, sertraline, paroxetine, trazodone, and citalopram. No apparent cases of serotonin toxicity (ST) occurred. Symptoms that occurred more frequently with the combination of AZILECT plus antidepressant could be accounted for as being symptoms of either antidepressant use or of depression.

"Rates of termination of treatment were similar, with and without antidepressants, further supporting the relative safety of AZILECT(R) (rasagiline tablets) combined with antidepressants," said Dr. Panisset. "Twenty four percent of the total number of AZILECT treated PD patients were also taking antidepressants. Seeing this apparent lack of serotonin toxicity is important."

According to the US prescribing information the exposure during development, both in dose and number of subjects was not adequate to rule out the possibility of an untoward reaction from combining AZILECT with antidepressants. Other MAO-B inhibitors are labeled similarly.

About AZILECT(R)

AZILECT is indicated for the treatment of the signs and symptoms of Parkinson's disease (PD) both as initial therapy alone and to be added to levodopa later in the disease. The effectiveness of AZILECT was shown in patients with early PD who were receiving AZILECT as initial therapy alone and who were not receiving any other PD therapy. The effectiveness of AZILECT as adjunct therapy was shown in patients with PD who were treated with levodopa.

-- You should not take AZILECT if you are currently taking meperidine as it could possibly result in a serious reaction such as coma or death.

-- You should not take AZILECT with tramadol, methadone, propoxyphene, dextromethorphan, St. John's wort, mirtazapine, or cyclobenzaprine.

-- You should not take AZILECT with other monoamine oxidase inhibitors (MAOIs), amphetamines, cold remedies containing decongestants and weight-reducing preparations containing pseudoephedrine, phenylephrine, phenylpropanolamine, or ephedrine in order to avoid a possibly dangerous increase in blood pressure. Symptoms of this reaction include severe headache, blurred vision, difficulty thinking, seizures, chest pain, unexplained nausea or vomiting, or signs or symptoms of a stroke. You or your caregiver should seek immediate medical attention if these symptoms or other unusual symptoms occur.

-- In order to prevent a possibly dangerous increase in blood pressure, when taking AZILECT you should avoid foods and beverages high in tyramine content such as aged cheeses, air-dried meats, pickled herring, yeast extract, aged red wines, tap/draft beers, sauerkraut, and soy sauce.

-- When taking AZILECT, you should not have elective surgery requiring general anesthesia, and should not receive cocaine or other local anesthesia that contains ingredients that could raise blood pressure. -- You should inform your physician if you are taking, or planning to take, any prescription or over-the-counter drugs, especially antidepressants and ciprofloxacin.

-- If you have moderate to severe liver disease or a tumor of the adrenal gland, you should not take AZILECT.

-- All PD patients are advised to monitor for melanoma (skin cancer) frequently and see a dermatologist on a regular basis.

Side effects seen with AZILECT alone are headache, joint pain and indigestion; and when taken with levodopa are uncontrolled movements (dyskinesias), accidental injury, nausea, weight loss, constipation, low blood pressure when standing, joint pain, vomiting, dry mouth, rash, and sleepiness. Be sure to tell your doctor about these and any other side effects you experience when taking AZILECT.