A drug used to treat patients with diabetes could offer fresh hope to those affected by the debilitating symptoms of Parkinson’s disease, according to BRC-supported research at the UCL Institute of Neurology and the National Hospital for Neurology and Neurosurgery (NHNN).
Parkinson’s Disease (PD), a degenerative disorder of the nervous system, affects at least one in 800 people, with an average age of onset of around 65–70 years.
Early in the course of the disease, the most obvious symptoms are movement-related; these include shaking, rigidity and difficulty with walking and gait. Later, thinking and behavioural problems may arise, with dementia commonly occurring in the advanced stages of the disease, whereas depression is the most common psychiatric symptom. Other symptoms include sensory, sleep and emotional problems.
In this month’s issue of the Journal of Clinical Investigation, Dr Thomas Foltynie and colleagues at the NHNN report the findings of an investigation into the use of a drug approved for diabetes care, Exenatide, in PD patients.
PD patients on the trial were divided into two groups: 20 patients received Exenatide injections for 12 months, while the other group of 24 patients served as controls. Due to high manufacturing costs, the control group did not receive placebo injections and the patients were aware of their group assignment.
The researchers observed that Exenatide was well tolerated. After one year of treatment patients receiving Exenatide displayed improved cognitive ability and motor skills, while control patients declined.
Though this trial cannot rule out a placebo effect, the study suggests that Exenatide may improve motor function in PD patients and provides a strong rationale for conducting a larger, blinded study to determine the effectiveness of Exenatide in PD. This study was funded by Cure Parkinson's Trust.
Dr Foltynie, consultant neurologist and senior lecturer, said: “This project shows that it is possible to get preliminary data in a very cost efficient way, regarding the possible effects of an already licensed drug in the treatment of patients with another condition.
“We are very grateful to the Cure Parkinson’s Trust for their dynamic approach to moving the Parkinson’s research field forward, and for raising the funds to allow this research to be performed. Limitations in the trial budget prevented the use of a placebo injection and so we must be careful not to send out the message that we have proven that this drug is helpful. However the data are certainly encouraging and provide a strong platform to move forward into double blind placebo controlled trials exploring the effects of Exenatide as a possible disease modifying drug in Parkinson’s disease.”
Patient Arthur Lindley, 63, said it was a ‘valuable trial’ which showed the drug has promise. Using the drug meant he had been able to go on an alpine holiday with his wife.
“Having Parkinson’s made everything I used to do rather more difficult, from just walking about the house and eating a meal, to standing and talking to people.
“My own personal conclusion is that, at the very least it stopped any further deterioration in my condition. For four months afterwards I certainly did not get any worse and my wife and GP felt that I had improved.”
Tom Isaacs, Co-founder and President, The Cure Parkinson’s Trust, said: “People with Parkinson’s guide the work of The Cure Parkinson’s Trust, informing research decisions and helping to prioritise areas of research, and this pivotal study was no exception. Perhaps most excitingly, the accompanying editorial in the journal cites that these results 'speak in favour of a disease-modifying effect' ; the Holy Grail in a condition where existing treatments only provide temporary relief from symptoms. In a disease area where there is little innovation, it is so exciting to see new research avenues open up, as through this approach we really will move ever closer to a cure or cures.”
The Cure Parkinson’s Trust is dedicated to finding a cure for Parkinson’s. The charity funds and facilitates research investing in potential new therapies to halt or reverse the disease process. www.cureparkinsons.org.uk registered charity number 1111816.
