Other Neurological/Neurodegenerative Diseases

Product	Indication	Status
Azilect® (rasagiline mesylate)	Parkinson's disease	Approved world-wide as a symptomatic treatment for both early patients, as monotherapy, and advanced patients, as adjuncive treatment to levodopa. A Phase IIIb to show effect on disease progression was just completed. Various phase IV studies on-going.
Talampanel	ALS	Phase II
Various other programs		Research

Azilect® (rasagiline mesylate) for Parkinson's Disease

Azilect® (rasagiline tablets) is Teva's second significant innovative drug, indicated for the treatment of Parkinson's disease, both as initial monotherapy in the early stage of the disease and as an adjunct to levodopa in moderate to advanced stages of the disease.

Azilect® is a potent, second-generation, irreversible monoamine oxidase type B (MAO-B) inhibitor with neuroprotective activities demonstrated in various in vitro and in vivo studies. Its beneficial clinical effect, seen in the entire spectrum of the disease, combined with its once-daily dosing, lack of need for titration and high tolerability, allows Azilect® to address significant unmet needs in the treatment of Parkinson's disease. Although many therapies are available, there is still a high level of dissatisfaction with many of these treatments, both in terms of their efficacy and tolerability. An estimated four million patients are affected by this chronic disease worldwide, which typically occurs at a late age, affecting approximately 1% of the population over the age of 65.

Teva launched Azilect® in its first market, Israel, in March 2005, followed by a rolling launch in various European countries, including the U.K. in June 2005 and Germany in July 2005. During July 2006, Azilect® became available in the U.S. To date, Azilect® has been made available in 29 countries, including Canada, Spain, Italy, Sweden, Belgium, Greece, Turkey, the Netherlands and Mexico.

The development of Azilect® is part of a long-term strategic alliance with Lundbeck, which includes the global co-development and marketing of Azilect®, mainly in Europe, for the treatment of Parkinson's disease.

Azilect® has demonstrated efficacy and safety in three pivotal studies that included over 1,500 patients with Parkinson's disease at different stages of the disease. In two Phase III studies with Azilect® as adjunctive therapy to levodopa in more advanced patients, Azilect® demonstrated beneficial effects in the two categories defined as the goals for adjunctive therapy in this disease: symptomatic control of Parkinsonian symptoms and treatment of levodopa-induced motor complications.

In the TEMPO Phase III study, conducted in North America in early stage patients, Azilect® demonstrated efficacy and safety as monotherapy treatment, showing a highly statistically significant effect on the progression of Parkinsonian symptoms and suggesting a possible effect on disease progression based on the 12-month results of the study. In an open extension of the TEMPO trial, approximately half of the patients who were still in the study after two years (121 out of 266) were adequately maintained on monotherapy with Azilect® (without additional dopaminergic treatment). In this same open extension, the results of six and one-half years follow-up of patients treated with Azilect® show that the benefit of early treatment is maintained over time.

In November 2005, Teva initiated a large, randomized, double-blind and placebo-controlled Phase IIIb clinical study to determine whether treatment with once-daily Azilect® can modify the progression of Parkinson's disease, the most significant current need of patients affected by this illness. The ADAGIO study (Attenuation of Disease progression with Azilect® Once-daily) enrolled 1,176 patients recently diagnosed with Parkinson's disease in North America, Europe and additional countries, including Israel and Argentina.

In June 16th, Teva announced the successful completion of ADAGIO, the phase III study designed to demonstrate that AZILECT® 1 mg tablets can slow down the progression of Parkinson's disease. In the trial, the currently marketed AZILECT® 1 mg tablets met all three primary end points, as well as the secondary and additional end points, all with statistical significance. The study also confirmed the safety and tolerability of AZILECT®.

Selected publications:

Abu-Raya, S. et al.: J. Neuroscience Research (1999); 58:456-463
Parkinson's Study Group (Siderowf A.): Arch. Neurolo. (2002); 59(12):1937-1943
Parkinson's Study Group (Siderowf A.): Arch. Neurolo. (2004); 61:561-566
Rascol, O. et al.: Lancet (2005); 365:947-954

For further information on Azilect: www.azilect.com

Talampanel for Amyotrophic Lateral Sclerosis and other neurodegenerative disease

Teva has exclusive worldwide rights to develop and market talampanel for the treatment of neurological disorders. Talampanel is an orally active antagonist of the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) neuronal excitatory glutamate receptor. Based on talampanel�s anti-glutamate excitatory activity, Teva believes that talampanel can significantly delay the functional deterioration of ALS patients. Based on the scientific, mechanistic rationale and a positive signal from a small Phase II study in ALS, Teva is proceeding with the development of talampanel for the latter indication, and a new Phase II study will commence during 2008.

Selected publications:

Chappell AS., Sander JW., Brodie MJ., et. al. A crossover, add-on trial of talampanel in patients with refractory partial seizures. Neurology (2002); 58(11):1680-1682
Ramsay R., Fetell M., Bell C: Efficacy in open extension phase of talampanel in refractory partial epilepsy. Neurology (2006);66, Suppl 2, A37